Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.26 / $34.26 / $34.26	Facility		$34.26	$34.26	$34.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.49 / $28.94 / $38.03	Professional		$21.49	$28.94	$38.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.60 / $92.09 / $92.09	Facility		$50.60	$92.09	$92.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.06 / $47.07 / $62.25	Professional		$47.06	$47.07	$62.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.15 / $30.92 / $108.31	Facility		$4.15	$30.92	$108.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.33 / $33.33 / $129.76	Facility		$33.33	$33.33	$129.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $55.88 / $69.84	Professional		$33.33	$55.88	$69.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.04 / $44.87 / $63.61	Facility		$18.04	$44.87	$63.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $36.22 / $66.37	Professional		$36.22	$36.22	$66.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.04 / $61.67 / $238.49	Facility		$18.04	$61.67	$238.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.68 / $30.66 / $62.74	Professional		$23.68	$30.66	$62.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $50.00 / $65.00	Professional		$19.57	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.04 / $45.41 / $63.61	Facility		$18.04	$45.41	$63.61
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $36.22 / $66.37	Professional		$36.22	$36.22	$66.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.68 / $11.83 / $15.36	Professional		$6.68	$11.83	$15.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $33.33 / $98.26 / $238.49	Facility		$33.33	$98.26	$238.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $33.33 / $43.75	Professional		$33.33	$33.33	$43.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.97 / $52.97 / $52.97	Professional		$52.97	$52.97	$52.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.97 / $52.97 / $52.97	Professional		$52.97	$52.97	$52.97
United Facility/Professional Professional Modifier Low / Median / High Price $20.07 / $31.78 / $52.97	Professional		$20.07	$31.78	$52.97