Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.75 / $25.75 / $25.75	Facility		$25.75	$25.75	$25.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.18 / $25.75 / $35.74	Professional		$21.18	$25.75	$35.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.36 / $48.80 / $80.73	Facility		$44.36	$48.80	$80.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.92 / $41.25 / $54.56	Professional		$39.92	$41.25	$54.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.92 / $94.93 / $94.93	Facility		$31.92	$94.93	$94.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.66 / $100.93 / $156.75	Facility		$26.66	$100.93	$156.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.66 / $55.72 / $83.95	Professional		$22.66	$55.72	$83.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.15 / $36.04 / $51.01	Facility		$12.15	$36.04	$51.01
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $21.59 / $39.22 / $53.23	Professional		$21.59	$39.22	$53.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.59 / $46.35 / $196.23	Facility		$21.59	$46.35	$196.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $22.38 / $49.42	Professional		$18.73	$22.38	$49.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.45 / $55.00 / $85.00	Professional		$5.45	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.15 / $37.71 / $51.01	Facility		$12.15	$37.71	$51.01
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $21.59 / $39.22 / $53.23	Professional		$21.59	$39.22	$53.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.36 / $68.28 / $112.41	Professional		$44.36	$68.28	$112.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26.66 / $86.64 / $196.23	Facility		$26.66	$86.64	$196.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.66 / $26.66 / $220.91	Professional		$22.66	$26.66	$220.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.36 / $44.36 / $44.36	Professional		$44.36	$44.36	$44.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.36 / $44.36 / $44.36	Professional		$44.36	$44.36	$44.36
United Facility/Professional Professional Modifier Low / Median / High Price $15.03 / $22.13 / $41.33	Professional		$15.03	$22.13	$41.33