Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.53 / $32.53 / $32.53	Facility		$32.53	$32.53	$32.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.23 / $25.48 / $32.53	Professional		$22.23	$25.48	$32.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.29 / $70.48 / $74.55	Facility		$58.29	$70.48	$74.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.11 / $45.77 / $108.44	Professional		$27.11	$45.77	$108.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.64 / $27.11 / $41.34	Facility		$18.64	$27.11	$41.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.79 / $87.40 / $134.08	Facility		$74.79	$87.40	$134.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.39 / $73.01 / $82.96	Professional		$31.39	$73.01	$82.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.37 / $24.40 / $34.70	Facility		$14.37	$24.40	$34.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.37 / $27.11 / $128.77	Facility		$14.37	$27.11	$128.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.72 / $27.11 / $56.93	Professional		$15.72	$27.11	$56.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $85.00	Professional		$55.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.37 / $24.40 / $34.70	Facility		$14.37	$24.40	$34.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $64.79 / $92.40	Professional		$31.92	$64.79	$92.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54.22 / $54.22 / $128.77	Facility		$54.22	$54.22	$128.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.37 / $14.37 / $14.37	Professional		$14.37	$14.37	$14.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $57.73 / $57.73	Professional		$57.73	$57.73	$57.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.33 / $148.02 / $148.02	Professional		$142.33	$148.02	$148.02
United Facility/Professional Facility Modifier Low / Median / High Price $13.56 / $21.69 / $27.11	Facility		$13.56	$21.69	$27.11
United Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $21.69 / $56.93	Professional		$13.56	$21.69	$56.93