Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.96 / $33.96 / $33.96	Facility		$33.96	$33.96	$33.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.65 / $26.86 / $40.39	Professional		$21.65	$26.86	$40.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $92.82 / $92.82	Facility		$51.00	$92.82	$92.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.38 / $47.43 / $68.84	Professional		$47.38	$47.43	$68.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.59 / $35.93 / $112.33	Facility		$3.59	$35.93	$112.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $26.10 / $139.66	Facility		$26.10	$26.10	$139.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $60.75 / $75.94	Professional		$26.10	$60.75	$75.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $16.91 / $49.40 / $61.13	Facility		$16.91	$49.40	$61.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $30.06 / $30.06 / $62.99	Professional		$30.06	$30.06	$62.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $16.91 / $62.99 / $252.49	Facility		$16.91	$62.99	$252.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $29.44 / $63.08	Professional		$22.33	$29.44	$63.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $50.00 / $65.00	Professional		$22.77	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $16.91 / $49.40 / $61.13	Facility		$16.91	$49.40	$61.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $30.06 / $30.06 / $62.99	Professional		$30.06	$30.06	$62.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.73 / $11.83 / $15.36	Professional		$6.73	$11.83	$15.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $98.94 / $252.49	Facility		$26.10	$98.94	$252.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $26.10 / $40.49	Professional		$26.10	$26.10	$40.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.50 / $52.50 / $52.50	Professional		$52.50	$52.50	$52.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.50 / $52.50 / $52.50	Professional		$52.50	$52.50	$52.50
United Facility/Professional Facility Modifier Low / Median / High Price $2.23 / $19.85 / $32.70	Facility		$2.23	$19.85	$32.70
United Facility/Professional Professional Modifier Low / Median / High Price $21.03 / $29.44 / $60.88	Professional		$21.03	$29.44	$60.88