Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.29 / $19.29 / $55.16	Facility		$19.29	$19.29	$55.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.52 / $19.29 / $28.47	Professional		$14.52	$19.29	$28.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $33.22 / $54.83	Facility		$33.22	$33.22	$54.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $33.22 / $37.88	Professional		$30.90	$33.22	$37.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $71.11 / $71.11	Facility		$33.22	$71.11	$71.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.21 / $104.25 / $138.56	Facility		$89.21	$104.25	$138.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $39.01 / $62.89	Professional		$13.56	$39.01	$62.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.66 / $27.01 / $33.22	Facility		$18.66	$27.01	$33.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $19.02 / $19.02 / $33.22	Professional		$19.02	$19.02	$33.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.82 / $27.38 / $34.72	Facility		$18.82	$27.38	$34.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.45 / $18.79 / $42.11	Professional		$15.45	$18.79	$42.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.43 / $65.00 / $85.00	Professional		$21.43	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.66 / $27.38 / $33.22	Facility		$18.66	$27.38	$33.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $19.02 / $19.02 / $33.22	Professional		$19.02	$19.02	$33.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $49.85 / $84.00	Professional		$33.22	$49.85	$84.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.90 / $67.45 / $156.36	Facility		$64.90	$67.45	$156.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $18.01 / $165.49	Professional		$13.56	$18.01	$165.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $33.22 / $33.22	Professional		$33.22	$33.22	$33.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $33.22 / $33.22	Professional		$33.22	$33.22	$33.22
United Facility/Professional Professional Modifier Low / Median / High Price $13.96 / $16.57 / $27.63	Professional		$13.96	$16.57	$27.63