Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.40 / $115.67 / $353.71	Facility		$14.40	$115.67	$353.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.67 / $10.13 / $20.62	Professional		$9.67	$10.13	$20.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.79 / $29.98 / $31.71	Facility		$24.79	$29.98	$31.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.61 / $4.61 / $47.03	Professional		$4.61	$4.61	$47.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.53 / $12.11 / $29.29	Facility		$11.53	$12.11	$29.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $11.53 / $11.53	Professional		$11.53	$11.53	$11.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.54 / $36.86 / $56.54	Facility		$31.54	$36.86	$56.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.22 / $21.73 / $35.29	Professional		$13.22	$21.73	$35.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.00 / $6.00 / $13.84	Facility		$6.00	$6.00	$13.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $6.00 / $58.68 / $172.75	Facility		$6.00	$58.68	$172.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $6.69 / $11.53 / $21.46	Professional		$6.69	$11.53	$21.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.71 / $11.53 / $85.00	Professional		$5.71	$11.53	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.00 / $6.00 / $13.84	Facility		$6.00	$6.00	$13.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.47 / $27.77 / $39.60	Professional		$15.47	$27.77	$39.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $23.06 / $23.06 / $60.00	Facility		$23.06	$23.06	$60.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.57 / $5.57 / $6.11	Professional		$5.57	$5.57	$6.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $11.53 / $24.55	Professional		$11.53	$11.53	$24.55
Security Health Facility/Professional Facility Modifier Low / Median / High Price $57.77 / $69.53 / $79.44	Facility		$57.77	$69.53	$79.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $33.51 / $62.95	Professional		$11.53	$33.51	$62.95
United Facility/Professional Facility Modifier Low / Median / High Price $11.53 / $11.53 / $11.53	Facility		$11.53	$11.53	$11.53
United Facility/Professional Professional Modifier Low / Median / High Price $5.77 / $11.53 / $35.56	Professional		$5.77	$11.53	$35.56