Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.78 / $38.78 / $38.78	Facility		$38.78	$38.78	$38.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.37 / $34.90 / $45.75	Professional		$24.37	$34.90	$45.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $105.56 / $105.56	Facility		$58.00	$105.56	$105.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $53.94 / $78.23	Professional		$53.89	$53.94	$78.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.37 / $32.74 / $124.01	Facility		$4.37	$32.74	$124.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.90 / $37.90 / $176.13	Facility		$37.90	$37.90	$176.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $67.13 / $83.91	Professional		$37.90	$67.13	$83.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.27 / $48.53 / $69.80	Facility		$19.27	$48.53	$69.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $40.31 / $72.79	Professional		$40.31	$40.31	$72.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.27 / $90.03 / $272.00	Facility		$19.27	$90.03	$272.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.31 / $34.51 / $72.79	Professional		$25.31	$34.51	$72.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $40.31 / $65.00	Professional		$24.18	$40.31	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.27 / $58.17 / $69.80	Facility		$19.27	$58.17	$69.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $40.31 / $72.79	Professional		$40.31	$40.31	$72.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.66 / $14.20 / $18.44	Professional		$7.66	$14.20	$18.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $37.90 / $112.54 / $272.00	Facility		$37.90	$112.54	$272.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $37.90 / $45.55	Professional		$37.90	$37.90	$45.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.31 / $59.31 / $59.31	Professional		$59.31	$59.31	$59.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.31 / $59.31 / $59.31	Professional		$59.31	$59.31	$59.31
United Facility/Professional Professional Modifier Low / Median / High Price $22.51 / $33.61 / $72.05	Professional		$22.51	$33.61	$72.05