Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.50 / $15.50 / $41.82	Facility		$15.50	$15.50	$41.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.28 / $15.50 / $22.87	Professional		$9.28	$15.50	$22.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.19 / $25.19 / $41.56	Facility		$25.19	$25.19	$41.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.43 / $25.19 / $28.71	Professional		$23.43	$25.19	$28.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.19 / $37.79 / $53.91	Facility		$25.19	$37.79	$53.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.45 / $31.37 / $58.40	Professional		$26.45	$31.37	$58.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.58 / $78.98 / $104.97	Facility		$67.58	$78.98	$104.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $36.56 / $47.40	Professional		$15.09	$36.56	$47.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.11 / $20.27 / $25.19	Facility		$15.11	$20.27	$25.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $18.11 / $18.11 / $25.19	Professional		$18.11	$18.11	$25.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.11 / $20.27 / $26.45	Facility		$15.11	$20.27	$26.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $15.52 / $36.68	Professional		$13.15	$15.52	$36.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.66 / $65.00 / $85.00	Professional		$33.66	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $15.11 / $20.27 / $25.19	Facility		$15.11	$20.27	$25.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $18.11 / $18.11 / $25.19	Professional		$18.11	$18.11	$25.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.19 / $42.62 / $75.00	Professional		$25.19	$42.62	$75.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $48.92 / $51.14 / $120.00	Facility		$48.92	$51.14	$120.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $110.07 / $125.45	Professional		$15.09	$110.07	$125.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28.41 / $28.41 / $28.41	Professional		$28.41	$28.41	$28.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28.41 / $28.41 / $28.41	Professional		$28.41	$28.41	$28.41
United Facility/Professional Professional Modifier Low / Median / High Price $11.64 / $14.11 / $24.88	Professional		$11.64	$14.11	$24.88