Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.87 / $31.87 / $91.12	Facility		$31.87	$31.87	$91.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.98 / $31.87 / $47.02	Professional		$23.98	$31.87	$47.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.89 / $54.89 / $90.57	Facility		$54.89	$54.89	$90.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.05 / $54.89 / $62.57	Professional		$51.05	$54.89	$62.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.89 / $117.46 / $117.46	Facility		$54.89	$117.46	$117.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.78 / $172.70 / $229.53	Facility		$147.78	$172.70	$229.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.02 / $79.69 / $103.88	Professional		$28.02	$79.69	$103.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.82 / $44.62 / $54.89	Facility		$30.82	$44.62	$54.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $31.42 / $54.89	Professional		$31.42	$31.42	$54.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.10 / $45.23 / $57.37	Facility		$31.10	$45.23	$57.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.52 / $31.03 / $69.54	Professional		$25.52	$31.03	$69.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.86 / $65.00 / $85.00	Professional		$17.86	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.82 / $45.23 / $54.89	Facility		$30.82	$45.23	$54.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $31.42 / $54.89	Professional		$31.42	$31.42	$54.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.89 / $82.34 / $139.00	Professional		$54.89	$82.34	$139.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $107.20 / $111.43 / $258.29	Facility		$107.20	$111.43	$258.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.02 / $241.20 / $273.35	Professional		$28.02	$241.20	$273.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.89 / $54.89 / $54.89	Professional		$54.89	$54.89	$54.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.89 / $54.89 / $54.89	Professional		$54.89	$54.89	$54.89
United Facility/Professional Professional Modifier Low / Median / High Price $23.27 / $27.38 / $50.83	Professional		$23.27	$27.38	$50.83