Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.87 / $19.87 / $19.87	Facility		$19.87	$19.87	$19.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.31 / $17.03 / $22.66	Professional		$12.31	$17.03	$22.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.82 / $32.79 / $54.27	Facility		$29.82	$32.79	$54.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $27.73 / $35.18	Professional		$14.40	$27.73	$35.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.44 / $63.81 / $63.81	Facility		$21.44	$63.81	$63.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.96 / $91.14 / $124.56	Facility		$18.96	$91.14	$124.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.12 / $43.13 / $56.44	Professional		$16.12	$43.13	$56.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.67 / $25.76 / $39.54	Facility		$15.67	$25.76	$39.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $35.78	Professional		$32.34	$32.34	$35.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.85 / $29.82 / $140.07	Facility		$17.85	$29.82	$140.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.64 / $19.02 / $142.71	Professional		$12.64	$19.02	$142.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.03 / $55.00 / $70.00	Professional		$15.03	$55.00	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $15.67 / $27.36 / $39.54	Facility		$15.67	$27.36	$39.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $35.78	Professional		$32.34	$32.34	$35.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.53 / $8.02 / $44.73	Professional		$4.53	$8.02	$44.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $47.77 / $58.24 / $140.07	Facility		$47.77	$58.24	$140.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.12 / $131.04 / $220.84	Professional		$16.12	$131.04	$220.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $29.82 / $29.82	Professional		$29.82	$29.82	$29.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $29.82 / $29.82	Professional		$29.82	$29.82	$29.82
United Facility/Professional Professional Modifier Low / Median / High Price $9.92 / $14.87 / $29.82	Professional		$9.92	$14.87	$29.82