Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $55.21 / $87.54	Facility		$25.13	$55.21	$87.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.69 / $25.13 / $31.45	Professional		$12.69	$25.13	$31.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.27 / $43.27 / $71.40	Facility		$43.27	$43.27	$71.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.24 / $43.27 / $49.32	Professional		$40.24	$43.27	$49.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.27 / $92.60 / $92.60	Facility		$43.27	$92.60	$92.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.24 / $135.84 / $180.54	Facility		$116.24	$135.84	$180.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.09 / $62.81 / $81.90	Professional		$22.09	$62.81	$81.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.30 / $35.18 / $43.27	Facility		$24.30	$35.18	$43.27
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.77 / $24.77 / $43.27	Professional		$24.77	$24.77	$43.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.51 / $35.65 / $45.23	Facility		$24.51	$35.65	$45.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $15.00 / $47.60	Professional		$15.00	$15.00	$47.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.30 / $58.40 / $85.00	Professional		$4.30	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.30 / $35.65 / $43.27	Facility		$24.30	$35.65	$43.27
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.77 / $24.77 / $43.27	Professional		$24.77	$24.77	$43.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.27 / $64.91 / $110.00	Professional		$43.27	$64.91	$110.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $84.52 / $87.84 / $203.25	Facility		$84.52	$87.84	$203.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.09 / $190.17 / $215.48	Professional		$22.09	$190.17	$215.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $43.27 / $43.27 / $43.27	Professional		$43.27	$43.27	$43.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $43.27 / $43.27 / $43.27	Professional		$43.27	$43.27	$43.27
United Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $15.00 / $20.54	Professional		$15.00	$15.00	$20.54