Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.94 / $25.94 / $25.94	Facility		$25.94	$25.94	$25.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.59 / $25.94 / $102.12	Professional		$24.59	$25.94	$102.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $35.40 / $58.41	Facility		$35.40	$35.40	$58.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.92 / $32.92 / $38.94	Professional		$32.92	$32.92	$38.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.86 / $75.76 / $75.76	Facility		$31.86	$75.76	$75.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.52 / $111.62 / $171.23	Facility		$95.52	$111.62	$171.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $51.09 / $67.00	Professional		$29.14	$51.09	$67.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.59 / $35.40 / $37.17	Facility		$24.59	$35.40	$37.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $12.56 / $12.56 / $12.56	Professional		$12.56	$12.56	$12.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.94 / $35.40 / $165.67	Facility		$25.94	$35.40	$165.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.66 / $40.02 / $107.48	Professional		$17.66	$40.02	$107.48
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 $24.59 / $35.40 / $37.17	Facility		$24.59	$35.40	$37.17
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $12.56 / $12.56 / $12.56	Professional		$12.56	$12.56	$12.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $53.74 / $106.39	Professional		$35.40	$53.74	$106.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $69.14 / $71.86 / $165.67	Facility		$69.14	$71.86	$165.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $29.14 / $29.14	Professional		$29.14	$29.14	$29.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $35.40 / $35.40	Professional		$35.40	$35.40	$35.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $35.40 / $35.40	Professional		$35.40	$35.40	$35.40
United Facility/Professional Professional Modifier Low / Median / High Price $13.83 / $35.32 / $107.88	Professional		$13.83	$35.32	$107.88