Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.65 / $28.65 / $28.65	Facility		$28.65	$28.65	$28.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.73 / $25.26 / $33.29	Professional		$17.73	$25.26	$33.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.60 / $77.53 / $77.53	Facility		$42.60	$77.53	$77.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $39.61 / $57.41	Professional		$39.54	$39.61	$57.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.00 / $29.98 / $97.69	Facility		$3.00	$29.98	$97.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.09 / $27.09 / $110.84	Facility		$27.09	$27.09	$110.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.09 / $48.00 / $60.00	Professional		$27.09	$48.00	$60.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.50 / $36.52 / $52.50	Facility		$12.50	$36.52	$52.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.14 / $26.14 / $54.78	Professional		$26.14	$26.14	$54.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.50 / $54.78 / $194.27	Facility		$12.50	$54.78	$194.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $22.57 / $50.81	Professional		$17.89	$22.57	$50.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $50.00 / $65.00	Professional		$20.46	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.50 / $36.52 / $52.50	Facility		$12.50	$36.52	$52.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.14 / $26.14 / $54.78	Professional		$26.14	$26.14	$54.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $9.47 / $12.29	Professional		$5.62	$9.47	$12.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $30.07 / $82.58 / $194.27	Facility		$30.07	$82.58	$194.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.09 / $27.09 / $35.54	Professional		$27.09	$27.09	$35.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $45.44 / $45.44 / $45.44	Professional		$45.44	$45.44	$45.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $45.44 / $45.44 / $45.44	Professional		$45.44	$45.44	$45.44
United Facility/Professional Professional Modifier Low / Median / High Price $16.12 / $22.57 / $50.81	Professional		$16.12	$22.57	$50.81