Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.04 / $21.04 / $21.04	Facility		$21.04	$21.04	$21.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.26 / $21.04 / $29.19	Professional		$11.26	$21.04	$29.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.24 / $39.86 / $65.95	Facility		$36.24	$39.86	$65.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $33.70 / $44.57	Professional		$32.61	$33.70	$44.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.07 / $77.55 / $77.55	Facility		$26.07	$77.55	$77.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.26 / $108.00 / $151.15	Facility		$24.26	$108.00	$151.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.71 / $53.34 / $68.59	Professional		$17.71	$53.34	$68.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.51 / $30.35 / $41.68	Facility		$10.51	$30.35	$41.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $20.75 / $36.24 / $43.49	Professional		$20.75	$36.24	$43.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.18 / $37.86 / $169.60	Facility		$18.18	$37.86	$169.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.72 / $24.22 / $42.74	Professional		$16.72	$24.22	$42.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.88 / $55.00 / $85.00	Professional		$18.88	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.51 / $31.35 / $41.68	Facility		$10.51	$31.35	$41.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $20.75 / $36.24 / $43.49	Professional		$20.75	$36.24	$43.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.24 / $55.76 / $97.36	Professional		$36.24	$55.76	$97.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $24.26 / $70.78 / $169.60	Facility		$24.26	$70.78	$169.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.71 / $24.26 / $180.48	Professional		$17.71	$24.26	$180.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.24 / $36.24 / $36.24	Professional		$36.24	$36.24	$36.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.24 / $36.24 / $36.24	Professional		$36.24	$36.24	$36.24
United Facility/Professional Professional Modifier Low / Median / High Price $14.44 / $21.74 / $34.65	Professional		$14.44	$21.74	$34.65