Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.56 / $153.00 / $715.66	Facility		$27.56	$153.00	$715.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.48 / $17.32 / $22.97	Professional		$12.48	$17.32	$22.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.39 / $59.72 / $63.17	Facility		$49.39	$59.72	$63.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.19 / $9.19 / $93.70	Professional		$9.19	$9.19	$93.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.97 / $24.12 / $58.34	Facility		$22.97	$24.12	$58.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.97 / $22.97 / $22.97	Professional		$22.97	$22.97	$22.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.08 / $73.70 / $113.08	Facility		$63.08	$73.70	$113.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.43 / $42.86 / $70.29	Professional		$26.43	$42.86	$70.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $11.94 / $11.94 / $27.56	Facility		$11.94	$11.94	$27.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $11.94 / $21.59 / $109.11	Facility		$11.94	$21.59	$109.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.32 / $22.97 / $48.24	Professional		$13.32	$22.97	$48.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.37 / $22.97 / $85.00	Professional		$11.37	$22.97	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $11.94 / $11.94 / $27.56	Facility		$11.94	$11.94	$27.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.52 / $54.76 / $78.09	Professional		$30.52	$54.76	$78.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.94 / $45.94 / $109.11	Facility		$45.94	$45.94	$109.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.15 / $11.15 / $12.17	Professional		$11.15	$11.15	$12.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.97 / $22.97 / $48.92	Professional		$22.97	$22.97	$48.92
Security Health Facility/Professional Facility Modifier Low / Median / High Price $115.08 / $138.51 / $158.26	Facility		$115.08	$138.51	$158.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.97 / $22.97 / $125.42	Professional		$22.97	$22.97	$125.42
United Facility/Professional Professional Modifier Low / Median / High Price $11.49 / $18.38 / $48.24	Professional		$11.49	$18.38	$48.24