Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.68 / $26.68 / $26.68	Facility		$26.68	$26.68	$26.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.38 / $23.00 / $30.74	Professional		$16.38	$23.00	$30.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $42.24 / $69.89	Facility		$38.40	$42.24	$69.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.71 / $35.72 / $47.25	Professional		$35.71	$35.72	$47.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.71 / $27.08 / $82.22	Facility		$2.71	$27.08	$82.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $39.02 / $159.55	Facility		$27.30	$39.02	$159.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.21 / $44.63 / $55.78	Professional		$23.21	$44.63	$55.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.61 / $34.38 / $46.10	Facility		$14.61	$34.38	$46.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $30.56 / $46.10	Professional		$30.56	$30.56	$46.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.61 / $48.02 / $182.85	Facility		$14.61	$48.02	$182.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.04 / $23.85 / $46.26	Professional		$18.04	$23.85	$46.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.95 / $55.00 / $65.00	Professional		$48.95	$55.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.61 / $38.42 / $46.10	Facility		$14.61	$38.42	$46.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $30.56 / $46.10	Professional		$30.56	$30.56	$46.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.73 / $8.68 / $12.10	Professional		$4.73	$8.68	$12.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $74.59 / $182.85	Facility		$27.30	$74.59	$182.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.21 / $27.30 / $29.21	Professional		$23.21	$27.30	$29.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $43.86 / $43.86 / $43.86	Professional		$43.86	$43.86	$43.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $43.86 / $43.86 / $43.86	Professional		$43.86	$43.86	$43.86
United Facility/Professional Professional Modifier Low / Median / High Price $15.58 / $24.72 / $40.53	Professional		$15.58	$24.72	$40.53