Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.97 / $19.97 / $19.97	Facility		$19.97	$19.97	$19.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $21.78 / $27.70	Professional		$19.97	$21.78	$27.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.40 / $37.84 / $62.61	Facility		$34.40	$37.84	$62.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.75 / $31.99 / $42.31	Professional		$29.75	$31.99	$42.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.74 / $73.62 / $73.62	Facility		$24.74	$73.62	$73.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.66 / $92.82 / $144.16	Facility		$20.66	$92.82	$144.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $50.48 / $65.09	Professional		$17.55	$50.48	$65.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $9.42 / $28.81 / $39.56	Facility		$9.42	$28.81	$39.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $19.70 / $34.40 / $41.28	Professional		$19.70	$34.40	$41.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $16.73 / $35.95 / $161.55	Facility		$16.73	$35.95	$161.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.70 / $17.16 / $37.45	Professional		$13.70	$17.16	$37.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.92 / $55.00 / $85.00	Professional		$9.92	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $9.42 / $29.96 / $39.56	Facility		$9.42	$29.96	$39.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $19.70 / $34.40 / $41.28	Professional		$19.70	$34.40	$41.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $52.92 / $87.32	Professional		$34.40	$52.92	$87.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $20.66 / $67.18 / $161.55	Facility		$20.66	$67.18	$161.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $20.66 / $171.31	Professional		$17.55	$20.66	$171.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $34.40 / $34.40	Professional		$34.40	$34.40	$34.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $34.40 / $34.40	Professional		$34.40	$34.40	$34.40
United Facility/Professional Professional Modifier Low / Median / High Price $11.44 / $17.16 / $29.09	Professional		$11.44	$17.16	$29.09