Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.36 / $26.36 / $26.36	Facility		$26.36	$26.36	$26.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.99 / $26.36 / $103.75	Professional		$24.99	$26.36	$103.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.96 / $35.96 / $59.33	Facility		$35.96	$35.96	$59.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.44 / $33.44 / $39.54	Professional		$33.44	$33.44	$39.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $76.95 / $76.95	Facility		$32.36	$76.95	$76.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $112.67 / $172.85	Facility		$96.42	$112.67	$172.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.14 / $52.03 / $68.06	Professional		$16.14	$52.03	$68.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.99 / $35.96 / $37.76	Facility		$24.99	$35.96	$37.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $12.82 / $12.82 / $12.82	Professional		$12.82	$12.82	$12.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.36 / $35.96 / $168.29	Facility		$26.36	$35.96	$168.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.94 / $40.65 / $109.20	Professional		$17.94	$40.65	$109.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $90.00	Professional		$65.00	$65.00	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.99 / $35.96 / $37.76	Facility		$24.99	$35.96	$37.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $12.82 / $12.82 / $12.82	Professional		$12.82	$12.82	$12.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.96 / $54.25 / $107.40	Professional		$35.96	$54.25	$107.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.23 / $73.00 / $168.29	Facility		$70.23	$73.00	$168.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.14 / $16.14 / $16.14	Professional		$16.14	$16.14	$16.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.96 / $35.96 / $35.96	Professional		$35.96	$35.96	$35.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.96 / $35.96 / $35.96	Professional		$35.96	$35.96	$35.96
United Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $35.88 / $109.20	Professional		$14.05	$35.88	$109.20