Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.40 / $21.40 / $21.40	Facility		$21.40	$21.40	$21.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.84 / $21.40 / $28.50	Professional		$19.84	$21.40	$28.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.85 / $40.54 / $67.06	Facility		$36.85	$40.54	$67.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $34.27 / $45.32	Professional		$33.15	$34.27	$45.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $78.86 / $78.86	Facility		$26.51	$78.86	$78.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.13 / $99.12 / $153.94	Facility		$22.13	$99.12	$153.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $53.44 / $69.75	Professional		$18.80	$53.44	$69.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.09 / $30.87 / $42.38	Facility		$10.09	$30.87	$42.38
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $21.11 / $36.85 / $44.22	Professional		$21.11	$36.85	$44.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.94 / $38.52 / $165.95	Facility		$17.94	$38.52	$165.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.62 / $18.84 / $42.75	Professional		$15.62	$18.84	$42.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.92 / $55.00 / $85.00	Professional		$15.92	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.09 / $32.10 / $42.38	Facility		$10.09	$32.10	$42.38
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $21.11 / $36.85 / $44.22	Professional		$21.11	$36.85	$44.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.85 / $56.72 / $93.34	Professional		$36.85	$56.72	$93.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $22.13 / $71.98 / $165.95	Facility		$22.13	$71.98	$165.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $22.13 / $194.85	Professional		$18.80	$22.13	$194.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.85 / $36.85 / $36.85	Professional		$36.85	$36.85	$36.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.85 / $36.85 / $36.85	Professional		$36.85	$36.85	$36.85
United Facility/Professional Professional Modifier Low / Median / High Price $13.02 / $18.38 / $36.85	Professional		$13.02	$18.38	$36.85