Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.87 / $22.87 / $22.87	Facility		$22.87	$22.87	$22.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.87 / $24.94 / $31.73	Professional		$22.87	$24.94	$31.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.38 / $43.32 / $71.67	Facility		$39.38	$43.32	$71.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $36.61 / $48.43	Professional		$36.61	$36.61	$48.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.34 / $84.27 / $84.27	Facility		$28.34	$84.27	$84.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.07 / $105.43 / $163.75	Facility		$26.07	$105.43	$163.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.07 / $57.19 / $74.54	Professional		$16.07	$57.19	$74.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.78 / $32.99 / $45.29	Facility		$10.78	$32.99	$45.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $22.55 / $39.38 / $47.26	Professional		$22.55	$39.38	$47.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.17 / $41.17 / $184.95	Facility		$19.17	$41.17	$184.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $19.64 / $42.89	Professional		$15.69	$19.64	$42.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.99 / $55.00 / $85.00	Professional		$18.99	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.78 / $34.31 / $45.29	Facility		$10.78	$34.31	$45.29
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $22.55 / $39.38 / $47.26	Professional		$22.55	$39.38	$47.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $60.62 / $100.37	Professional		$39.38	$60.62	$100.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26.07 / $76.92 / $184.95	Facility		$26.07	$76.92	$184.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.07 / $26.07 / $196.11	Professional		$16.07	$26.07	$196.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $39.38 / $39.38	Professional		$39.38	$39.38	$39.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $39.38 / $39.38	Professional		$39.38	$39.38	$39.38
United Facility/Professional Professional Modifier Low / Median / High Price $13.10 / $19.64 / $39.38	Professional		$13.10	$19.64	$39.38