Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.40 / $31.40 / $31.40	Facility		$31.40	$31.40	$31.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.56 / $31.40 / $44.56	Professional		$21.56	$31.40	$44.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.08 / $59.49 / $98.43	Facility		$54.08	$59.49	$98.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $50.29 / $66.51	Professional		$50.29	$50.29	$66.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $115.73 / $115.73	Facility		$38.90	$115.73	$115.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.60 / $161.00 / $225.33	Facility		$35.60	$161.00	$225.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.99 / $79.53 / $102.35	Professional		$25.99	$79.53	$102.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.40 / $46.79 / $62.19	Facility		$31.40	$46.79	$62.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $64.90 / $64.90	Professional		$54.08	$64.90	$64.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.65 / $56.52 / $253.09	Facility		$35.65	$56.52	$253.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.28 / $32.45 / $63.76	Professional		$24.28	$32.45	$63.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.44 / $58.40 / $85.00	Professional		$32.44	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.40 / $47.10 / $62.19	Facility		$31.40	$47.10	$62.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $64.90 / $64.90	Professional		$54.08	$64.90	$64.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $81.12 / $145.54	Professional		$54.08	$81.12	$145.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $35.60 / $105.62 / $253.09	Facility		$35.60	$105.62	$253.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.99 / $35.60 / $269.32	Professional		$25.99	$35.60	$269.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $54.08 / $54.08	Professional		$54.08	$54.08	$54.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $54.08 / $54.08	Professional		$54.08	$54.08	$54.08
United Facility/Professional Professional Modifier Low / Median / High Price $20.23 / $28.32 / $51.70	Professional		$20.23	$28.32	$51.70