Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.69 / $29.45 / $29.45	Professional		$25.69	$29.45	$29.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.36 / $81.45 / $86.16	Facility		$67.36	$81.45	$86.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.54 / $6.54 / $127.81	Professional		$6.54	$6.54	$127.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.56 / $31.33 / $47.75	Facility		$21.56	$31.33	$47.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.51 / $101.09 / $155.08	Facility		$86.51	$101.09	$155.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.93 / $84.37 / $95.88	Professional		$35.93	$84.37	$95.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $16.61 / $28.20 / $40.10	Facility		$16.61	$28.20	$40.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $16.61 / $31.33 / $148.82	Facility		$16.61	$31.33	$148.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $31.33 / $65.79	Professional		$18.17	$31.33	$65.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $86.47	Professional		$55.00	$65.00	$86.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $16.61 / $28.20 / $40.10	Facility		$16.61	$28.20	$40.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $74.81 / $106.70	Professional		$36.86	$74.81	$106.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $62.66 / $62.66 / $148.82	Facility		$62.66	$62.66	$148.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $16.60 / $16.60	Professional		$16.60	$16.60	$16.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.72 / $66.72 / $66.72	Professional		$66.72	$66.72	$66.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $164.48 / $171.06 / $171.06	Professional		$164.48	$171.06	$171.06
United Facility/Professional Professional Modifier Low / Median / High Price $15.67 / $25.06 / $65.79	Professional		$15.67	$25.06	$65.79