Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $37.92 / $37.92	Facility		$37.92	$37.92	$37.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.76 / $33.22 / $42.71	Professional		$22.76	$33.22	$42.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.30 / $102.47 / $102.47	Facility		$56.30	$102.47	$102.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.30 / $52.36 / $75.92	Professional		$52.30	$52.36	$75.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.37 / $32.69 / $120.35	Facility		$4.37	$32.69	$120.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.56 / $35.56 / $164.86	Facility		$35.56	$35.56	$164.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.56 / $63.00 / $78.75	Professional		$35.56	$63.00	$78.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $16.57 / $48.45 / $69.64	Facility		$16.57	$48.45	$69.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $34.68 / $34.68 / $72.67	Professional		$34.68	$34.68	$72.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $16.57 / $69.64 / $255.06	Facility		$16.57	$69.64	$255.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.75 / $30.44 / $68.54	Professional		$23.75	$30.44	$68.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.29 / $50.00 / $65.00	Professional		$17.29	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $16.57 / $48.45 / $69.64	Facility		$16.57	$48.45	$69.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $34.68 / $34.68 / $72.67	Professional		$34.68	$34.68	$72.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.43 / $12.62 / $16.39	Professional		$7.43	$12.62	$16.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $46.67 / $109.20 / $255.06	Facility		$46.67	$109.20	$255.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.56 / $35.56 / $46.67	Professional		$35.56	$35.56	$46.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.96 / $59.96 / $59.96	Professional		$59.96	$59.96	$59.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.96 / $59.96 / $59.96	Professional		$59.96	$59.96	$59.96
United Facility/Professional Professional Modifier Low / Median / High Price $19.77 / $28.87 / $59.96	Professional		$19.77	$28.87	$59.96