Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.58 / $27.58 / $27.58	Facility		$27.58	$27.58	$27.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.27 / $30.30 / $38.96	Professional		$18.27	$30.30	$38.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.51 / $52.26 / $86.47	Facility		$47.51	$52.26	$86.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $44.18 / $58.43	Professional		$42.75	$44.18	$58.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.18 / $101.67 / $101.67	Facility		$34.18	$101.67	$101.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.06 / $127.96 / $198.74	Facility		$29.06	$127.96	$198.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $70.01 / $89.93	Professional		$24.70	$70.01	$89.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.24 / $40.52 / $54.64	Facility		$13.24	$40.52	$54.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $47.51 / $57.01	Professional		$27.70	$47.51	$57.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.54 / $49.64 / $218.60	Facility		$23.54	$49.64	$218.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.45 / $24.72 / $55.08	Professional		$20.45	$24.72	$55.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $55.00 / $85.00	Professional		$22.91	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.24 / $41.37 / $54.64	Facility		$13.24	$41.37	$54.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $47.51 / $57.01	Professional		$27.70	$47.51	$57.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $73.12 / $123.46	Professional		$47.51	$73.12	$123.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $29.06 / $92.80 / $218.60	Facility		$29.06	$92.80	$218.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $29.06 / $248.81	Professional		$24.70	$29.06	$248.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $47.51 / $47.51	Professional		$47.51	$47.51	$47.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $47.51 / $47.51	Professional		$47.51	$47.51	$47.51
United Facility/Professional Professional Modifier Low / Median / High Price $17.10 / $23.70 / $47.51	Professional		$17.10	$23.70	$47.51