Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.77 / $30.77 / $30.77	Facility		$30.77	$30.77	$30.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.52 / $26.78 / $30.93	Professional		$16.52	$26.78	$30.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.30 / $84.27 / $84.27	Facility		$46.30	$84.27	$84.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $43.06 / $62.34	Professional		$42.95	$43.06	$62.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.33 / $24.78 / $98.83	Facility		$3.33	$24.78	$98.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.37 / $28.37 / $119.85	Facility		$28.37	$28.37	$119.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.37 / $51.75 / $64.69	Professional		$28.37	$51.75	$64.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.65 / $30.77 / $55.39	Facility		$12.65	$30.77	$55.39
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.45 / $26.45 / $55.42	Professional		$26.45	$26.45	$55.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.65 / $55.42 / $204.80	Facility		$12.65	$55.42	$204.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.79 / $23.04 / $51.44	Professional		$17.79	$23.04	$51.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.65 / $30.77 / $55.39	Facility		$12.65	$30.77	$55.39
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.45 / $26.45 / $55.42	Professional		$26.45	$26.45	$55.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.11 / $9.47 / $12.29	Professional		$6.11	$9.47	$12.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $28.37 / $90.20 / $204.80	Facility		$28.37	$90.20	$204.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.37 / $28.37 / $31.70	Professional		$28.37	$28.37	$31.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $46.18 / $46.18	Professional		$46.18	$46.18	$46.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $46.18 / $46.18	Professional		$46.18	$46.18	$46.18
United Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $23.04 / $48.96	Professional		$16.32	$23.04	$48.96