Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.46 / $75.25 / $141.12	Facility		$14.46	$75.25	$141.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.88 / $12.94 / $14.46	Professional		$9.88	$12.94	$14.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.91 / $31.33 / $33.14	Facility		$25.91	$31.33	$33.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.82 / $4.82 / $49.16	Professional		$4.82	$4.82	$49.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.05 / $12.65 / $30.61	Facility		$12.05	$12.65	$30.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.05 / $12.05 / $12.05	Professional		$12.05	$12.05	$12.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.34 / $38.96 / $59.77	Facility		$33.34	$38.96	$59.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.63 / $22.33 / $36.88	Professional		$13.63	$22.33	$36.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.27 / $6.27 / $14.46	Facility		$6.27	$6.27	$14.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $6.27 / $12.05 / $117.43	Facility		$6.27	$12.05	$117.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $6.99 / $12.05 / $25.31	Professional		$6.99	$12.05	$25.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.96 / $12.05 / $85.00	Professional		$5.96	$12.05	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.27 / $6.27 / $14.46	Facility		$6.27	$6.27	$14.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.90 / $28.54 / $40.70	Professional		$15.90	$28.54	$40.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $24.10 / $24.10 / $60.00	Facility		$24.10	$24.10	$60.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.89 / $5.89 / $6.39	Professional		$5.89	$5.89	$6.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $12.05 / $12.05 / $25.66	Professional		$12.05	$12.05	$25.66
Security Health Facility/Professional Facility Modifier Low / Median / High Price $60.37 / $72.66 / $83.02	Facility		$60.37	$72.66	$83.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $12.05 / $35.02 / $65.79	Professional		$12.05	$35.02	$65.79
United Facility/Professional Facility Modifier Low / Median / High Price $9.64 / $9.64 / $26.15	Facility		$9.64	$9.64	$26.15
United Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $9.64 / $25.31	Professional		$6.03	$9.64	$25.31