Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.38 / $23.38 / $23.38	Facility		$23.38	$23.38	$23.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.08 / $23.38 / $30.66	Professional		$21.08	$23.38	$30.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.26 / $40.26 / $66.43	Facility		$40.26	$40.26	$66.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $40.26 / $47.50	Professional		$37.44	$40.26	$47.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.26 / $86.16 / $86.16	Facility		$40.26	$86.16	$86.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.13 / $126.36 / $167.95	Facility		$108.13	$126.36	$167.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.44 / $59.06 / $76.20	Professional		$32.44	$59.06	$76.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.99 / $32.57 / $40.26	Facility		$22.99	$32.57	$40.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $40.26 / $40.26	Professional		$40.26	$40.26	$40.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.38 / $32.57 / $41.59	Facility		$23.38	$32.57	$41.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.15 / $24.16 / $57.11	Professional		$21.15	$24.16	$57.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.99 / $32.72 / $40.26	Facility		$22.99	$32.72	$40.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $40.26 / $40.26	Professional		$40.26	$40.26	$40.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $60.39 / $118.44	Professional		$40.26	$60.39	$118.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $78.64 / $81.73 / $188.32	Facility		$78.64	$81.73	$188.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.44 / $176.94 / $199.29	Professional		$32.44	$176.94	$199.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $40.26 / $40.26	Professional		$40.26	$40.26	$40.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $40.26 / $40.26	Professional		$40.26	$40.26	$40.26
United Facility/Professional Professional Modifier Low / Median / High Price $19.04 / $21.15 / $37.40	Professional		$19.04	$21.15	$37.40