Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.83 / $23.83 / $68.13	Facility		$23.83	$23.83	$68.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.93 / $23.83 / $35.15	Professional		$17.93	$23.83	$35.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.04 / $41.04 / $67.72	Facility		$41.04	$41.04	$67.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.17 / $41.04 / $46.78	Professional		$38.17	$41.04	$46.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.04 / $87.83 / $87.83	Facility		$41.04	$87.83	$87.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.94 / $128.47 / $170.75	Facility		$109.94	$128.47	$170.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.95 / $59.53 / $77.68	Professional		$20.95	$59.53	$77.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.05 / $33.36 / $41.04	Facility		$23.05	$33.36	$41.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $23.50 / $41.04	Professional		$23.50	$23.50	$41.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.25 / $33.82 / $42.89	Facility		$23.25	$33.82	$42.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.07 / $23.20 / $52.00	Professional		$19.07	$23.20	$52.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $65.00 / $85.00	Professional		$26.25	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.05 / $33.82 / $41.04	Facility		$23.05	$33.82	$41.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $23.50 / $41.04	Professional		$23.50	$23.50	$41.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.04 / $61.56 / $104.00	Professional		$41.04	$61.56	$104.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $80.16 / $83.31 / $193.10	Facility		$80.16	$83.31	$193.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.95 / $180.36 / $204.38	Professional		$20.95	$180.36	$204.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.04 / $41.04 / $41.04	Professional		$41.04	$41.04	$41.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.04 / $41.04 / $41.04	Professional		$41.04	$41.04	$41.04
United Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $20.47 / $38.01	Professional		$17.25	$20.47	$38.01