Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.99 / $24.99 / $24.99	Facility		$24.99	$24.99	$24.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.28 / $21.96 / $28.68	Professional		$15.28	$21.96	$28.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.20 / $65.88 / $65.88	Facility		$36.20	$65.88	$65.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.33 / $33.67 / $44.69	Professional		$28.33	$33.67	$44.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.54 / $25.52 / $90.97	Facility		$2.54	$25.52	$90.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.28 / $23.28 / $93.72	Facility		$23.28	$23.28	$93.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.28 / $40.50 / $50.63	Professional		$23.28	$40.50	$50.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.00 / $34.01 / $48.89	Facility		$21.00	$34.01	$48.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $24.33 / $51.01	Professional		$24.33	$24.33	$51.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.00 / $48.89 / $167.12	Facility		$21.00	$48.89	$167.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $21.10 / $45.35	Professional		$15.50	$21.10	$45.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.12 / $50.00 / $65.00	Professional		$12.12	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.00 / $34.01 / $48.89	Facility		$21.00	$34.01	$48.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $24.33 / $51.01	Professional		$24.33	$24.33	$51.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.78 / $7.89 / $10.24	Professional		$4.78	$7.89	$10.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $29.01 / $70.28 / $167.12	Facility		$29.01	$70.28	$167.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.28 / $23.28 / $30.56	Professional		$23.28	$23.28	$30.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.57 / $40.57 / $40.57	Professional		$40.57	$40.57	$40.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.57 / $40.57 / $40.57	Professional		$40.57	$40.57	$40.57
United Facility/Professional Professional Modifier Low / Median / High Price $12.77 / $20.14 / $40.57	Professional		$12.77	$20.14	$40.57