Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.94 / $24.94 / $24.94	Facility		$24.94	$24.94	$24.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.94 / $27.20 / $34.60	Professional		$24.94	$27.20	$34.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.96 / $47.26 / $78.19	Facility		$42.96	$47.26	$78.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $39.95 / $52.84	Professional		$38.65	$39.95	$52.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $91.93 / $91.93	Facility		$30.90	$91.93	$91.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.81 / $115.34 / $179.14	Facility		$25.81	$115.34	$179.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $63.34 / $81.30	Professional		$21.94	$63.34	$81.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $11.76 / $35.97 / $49.40	Facility		$11.76	$35.97	$49.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.60 / $42.96 / $51.55	Professional		$24.60	$42.96	$51.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.91 / $44.89 / $201.75	Facility		$20.91	$44.89	$201.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.11 / $21.43 / $46.78	Professional		$17.11	$21.43	$46.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.64 / $55.00 / $85.00	Professional		$20.64	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $11.76 / $37.40 / $49.40	Facility		$11.76	$37.40	$49.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.60 / $42.96 / $51.55	Professional		$24.60	$42.96	$51.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.96 / $66.09 / $109.40	Professional		$42.96	$66.09	$109.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $25.81 / $83.90 / $201.75	Facility		$25.81	$83.90	$201.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $25.81 / $213.94	Professional		$21.94	$25.81	$213.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.96 / $42.96 / $42.96	Professional		$42.96	$42.96	$42.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.96 / $42.96 / $42.96	Professional		$42.96	$42.96	$42.96
United Facility/Professional Professional Modifier Low / Median / High Price $14.29 / $21.43 / $42.96	Professional		$14.29	$21.43	$42.96