Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.26 / $26.26 / $175.50	Facility		$26.26	$26.26	$175.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.22 / $26.26 / $110.94	Professional		$24.22	$26.26	$110.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.74 / $32.74 / $54.02	Facility		$32.74	$32.74	$54.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.45 / $30.45 / $36.01	Professional		$30.45	$30.45	$36.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.47 / $70.06 / $70.06	Facility		$29.47	$70.06	$70.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.80 / $97.93 / $150.22	Facility		$83.80	$97.93	$150.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.70 / $45.47 / $61.61	Professional		$18.70	$45.47	$61.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.22 / $32.74 / $34.38	Facility		$24.22	$32.74	$34.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.26 / $34.38 / $158.61	Facility		$26.26	$34.38	$158.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.75 / $51.89 / $125.77	Professional		$17.75	$51.89	$125.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $65.00 / $90.00	Professional		$37.59	$65.00	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.22 / $32.74 / $34.38	Facility		$24.22	$32.74	$34.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.74 / $58.80 / $98.36	Professional		$32.74	$58.80	$98.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $63.58 / $66.45 / $158.61	Facility		$63.58	$66.45	$158.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.70 / $18.70 / $18.70	Professional		$18.70	$18.70	$18.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.34 / $41.34 / $41.34	Professional		$41.34	$41.34	$41.34
Security Health Facility/Professional Facility Modifier Low / Median / High Price $47.77 / $47.77 / $47.77	Facility		$47.77	$47.77	$47.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.34 / $41.34 / $41.34	Professional		$41.34	$41.34	$41.34
United Facility/Professional Facility Modifier Low / Median / High Price $32.74 / $32.74 / $32.74	Facility		$32.74	$32.74	$32.74
United Facility/Professional Professional Modifier Low / Median / High Price $12.21 / $43.95 / $115.42	Professional		$12.21	$43.95	$115.42