Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.11 / $22.11 / $63.20	Facility		$22.11	$22.11	$63.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.64 / $22.11 / $32.61	Professional		$16.64	$22.11	$32.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.07 / $38.07 / $62.82	Facility		$38.07	$38.07	$62.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $38.07 / $43.39	Professional		$35.40	$38.07	$43.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.07 / $81.47 / $81.47	Facility		$38.07	$81.47	$81.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.73 / $120.05 / $159.55	Facility		$102.73	$120.05	$159.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.44 / $55.31 / $72.05	Professional		$19.44	$55.31	$72.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $30.95 / $38.07	Facility		$21.38	$30.95	$38.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $21.80 / $21.80 / $38.07	Professional		$21.80	$21.80	$38.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.57 / $31.38 / $39.79	Facility		$21.57	$31.38	$39.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.70 / $21.53 / $48.24	Professional		$17.70	$21.53	$48.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.75 / $65.00 / $85.00	Professional		$19.75	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $31.38 / $38.07	Facility		$21.38	$31.38	$38.07
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $21.80 / $21.80 / $38.07	Professional		$21.80	$21.80	$38.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.07 / $57.11 / $97.00	Professional		$38.07	$57.11	$97.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $74.36 / $77.28 / $179.15	Facility		$74.36	$77.28	$179.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.44 / $167.31 / $189.59	Professional		$19.44	$167.31	$189.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $38.07 / $38.07 / $38.07	Professional		$38.07	$38.07	$38.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $38.07 / $38.07 / $38.07	Professional		$38.07	$38.07	$38.07
United Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $19.00 / $35.47	Professional		$16.00	$19.00	$35.47