Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.11 / $35.11 / $35.11	Facility		$35.11	$35.11	$35.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.88 / $35.11 / $39.72	Professional		$20.88	$35.11	$39.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.30 / $93.37 / $93.37	Facility		$51.30	$93.37	$93.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.69 / $49.95 / $69.25	Professional		$47.69	$49.95	$69.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.62 / $36.15 / $125.08	Facility		$3.62	$36.15	$125.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.91 / $31.91 / $156.66	Facility		$31.91	$31.91	$156.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.91 / $60.00 / $75.00	Professional		$31.91	$60.00	$75.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.86 / $46.76 / $67.22	Facility		$32.86	$46.76	$67.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $70.14 / $70.14 / $70.14	Professional		$70.14	$70.14	$70.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.86 / $67.22 / $228.57	Facility		$32.86	$67.22	$228.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.52 / $30.71 / $59.85	Professional		$22.52	$30.71	$59.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.54 / $50.00 / $65.00	Professional		$18.54	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $32.86 / $52.68 / $67.22	Facility		$32.86	$52.68	$67.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $70.14 / $70.14 / $70.14	Professional		$70.14	$70.14	$70.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.77 / $11.04 / $14.34	Professional		$6.77	$11.04	$14.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $31.91 / $99.58 / $228.57	Facility		$31.91	$99.58	$228.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.91 / $31.91 / $39.89	Professional		$31.91	$31.91	$39.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.56 / $55.56 / $55.56	Professional		$55.56	$55.56	$55.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.56 / $55.56 / $55.56	Professional		$55.56	$55.56	$55.56
United Facility/Professional Professional Modifier Low / Median / High Price $18.43 / $28.67 / $56.97	Professional		$18.43	$28.67	$56.97