Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.01 / $29.01 / $29.01	Facility		$29.01	$29.01	$29.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.08 / $29.01 / $121.14	Professional		$27.08	$29.01	$121.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.79 / $37.79 / $62.35	Facility		$37.79	$37.79	$62.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.14 / $35.14 / $41.56	Professional		$35.14	$35.14	$41.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.01 / $80.87 / $80.87	Facility		$34.01	$80.87	$80.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.12 / $115.83 / $177.69	Facility		$99.12	$115.83	$177.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.50 / $53.44 / $71.09	Professional		$25.50	$53.44	$71.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.08 / $37.79 / $39.68	Facility		$27.08	$37.79	$39.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.01 / $37.79 / $184.63	Facility		$29.01	$37.79	$184.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.60 / $53.30 / $131.86	Professional		$19.60	$53.30	$131.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $90.00 / $125.90	Professional		$65.00	$90.00	$125.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.08 / $37.79 / $39.68	Facility		$27.08	$37.79	$39.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $65.40 / $109.40	Professional		$37.79	$65.40	$109.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.38 / $76.70 / $184.63	Facility		$73.38	$76.70	$184.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.50 / $25.50 / $25.50	Professional		$25.50	$25.50	$25.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $44.45 / $44.45	Professional		$44.45	$44.45	$44.45
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 $44.45 / $44.45 / $44.45	Professional		$44.45	$44.45	$44.45
United Facility/Professional Facility Modifier Low / Median / High Price $54.89 / $54.89 / $54.89	Facility		$54.89	$54.89	$54.89
United Facility/Professional Professional Modifier Low / Median / High Price $14.36 / $44.71 / $119.28	Professional		$14.36	$44.71	$119.28