Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.97 / $43.97 / $43.97	Facility		$43.97	$43.97	$43.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.86 / $38.40 / $52.28	Professional		$27.86	$38.40	$52.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.90 / $112.66 / $112.66	Facility		$61.90	$112.66	$112.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.09 / $57.57 / $77.37	Professional		$52.09	$57.57	$77.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.17 / $43.23 / $132.47	Facility		$6.17	$43.23	$132.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.67 / $42.67 / $161.30	Facility		$42.67	$42.67	$161.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.67 / $70.13 / $87.66	Professional		$42.67	$70.13	$87.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.44 / $64.06 / $92.08	Facility		$25.44	$64.06	$92.08
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.21 / $53.21 / $96.08	Professional		$53.21	$53.21	$96.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.44 / $96.08 / $305.83	Facility		$25.44	$96.08	$305.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.43 / $43.25 / $79.50	Professional		$30.43	$43.25	$79.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $50.00 / $65.00	Professional		$31.92	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.44 / $64.06 / $92.08	Facility		$25.44	$64.06	$92.08
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $53.21 / $53.21 / $96.08	Professional		$53.21	$53.21	$96.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.17 / $14.20 / $18.44	Professional		$8.17	$14.20	$18.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $42.67 / $120.20 / $305.83	Facility		$42.67	$120.20	$305.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.67 / $42.67 / $49.20	Professional		$42.67	$42.67	$49.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.18 / $74.18 / $74.18	Professional		$74.18	$74.18	$74.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.18 / $74.18 / $74.18	Professional		$74.18	$74.18	$74.18
United Facility/Professional Professional Modifier Low / Median / High Price $27.32 / $43.21 / $74.18	Professional		$27.32	$43.21	$74.18