Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.11 / $50.08 / $85.80	Facility		$16.11	$50.08	$85.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.01 / $25.38 / $64.84	Professional		$17.01	$25.38	$64.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.94 / $49.90 / $51.76	Facility		$42.94	$49.90	$51.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.90 / $20.90 / $28.32	Professional		$20.90	$20.90	$28.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $48.53 / $48.53	Facility		$37.15	$48.53	$48.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.95 / $54.24 / $77.53	Facility		$22.95	$54.24	$77.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.95 / $24.30 / $28.45	Professional		$22.95	$24.30	$28.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.01 / $22.35 / $35.82	Facility		$13.01	$22.35	$35.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $46.44 / $46.44 / $46.44	Professional		$46.44	$46.44	$46.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.30 / $22.35 / $63.84	Facility		$17.30	$22.35	$63.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.87 / $23.92 / $46.44	Professional		$20.87	$23.92	$46.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.35 / $54.53 / $85.00	Professional		$22.35	$54.53	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.01 / $22.35 / $35.82	Facility		$13.01	$22.35	$35.82
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $46.44 / $46.44 / $46.44	Professional		$46.44	$46.44	$46.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.22 / $48.28 / $75.90	Professional		$23.22	$48.28	$75.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.95 / $22.95 / $22.95	Professional		$22.95	$22.95	$22.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.86 / $32.60 / $32.60	Professional		$29.86	$32.60	$32.60
United Facility/Professional Facility Modifier Low / Median / High Price $22.35 / $22.35 / $22.35	Facility		$22.35	$22.35	$22.35
United Facility/Professional Professional Modifier Low / Median / High Price $20.87 / $23.58 / $34.22	Professional		$20.87	$23.58	$34.22