Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.03 / $28.03 / $28.03	Facility		$28.03	$28.03	$28.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.97 / $23.05 / $33.71	Professional		$17.97	$23.05	$33.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.20 / $65.88 / $65.88	Facility		$36.20	$65.88	$65.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.67 / $33.70 / $50.50	Professional		$33.67	$33.70	$50.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.54 / $25.55 / $129.72	Facility		$2.54	$25.55	$129.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.27 / $31.85 / $64.80	Facility		$24.27	$31.85	$64.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.27 / $42.38 / $52.97	Professional		$24.27	$42.38	$52.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $48.50 / $69.70	Facility		$16.60	$48.50	$69.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $34.71 / $72.73	Professional		$34.71	$34.71	$72.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.03 / $72.73 / $174.00	Facility		$28.03	$72.73	$174.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $29.71 / $52.68	Professional		$20.05	$29.71	$52.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $50.00 / $65.00	Professional		$25.30	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $48.50 / $69.70	Facility		$16.60	$48.50	$69.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $34.71 / $72.73	Professional		$34.71	$34.71	$72.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.78 / $7.89 / $10.24	Professional		$4.78	$7.89	$10.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $31.85 / $70.38 / $174.00	Facility		$31.85	$70.38	$174.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.27 / $24.27 / $32.49	Professional		$24.27	$24.27	$32.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.11 / $50.11 / $50.11	Professional		$50.11	$50.11	$50.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.11 / $50.11 / $50.11	Professional		$50.11	$50.11	$50.11
United Facility/Professional Facility Modifier Low / Median / High Price $2.18 / $16.39 / $25.96	Facility		$2.18	$16.39	$25.96
United Facility/Professional Professional Modifier Low / Median / High Price $16.72 / $27.80 / $50.35	Professional		$16.72	$27.80	$50.35