Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.32 / $35.32 / $35.32	Facility		$35.32	$35.32	$35.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $26.87 / $42.47	Professional		$22.63	$26.87	$42.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.60 / $84.81 / $84.81	Facility		$46.60	$84.81	$84.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.31 / $46.57 / $64.95	Professional		$43.31	$46.57	$64.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5.31 / $32.84 / $118.21	Facility		$5.31	$32.84	$118.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.00 / $31.00 / $124.35	Facility		$31.00	$31.00	$124.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $54.00 / $67.50	Professional		$31.00	$54.00	$67.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.40 / $58.92 / $88.38	Facility		$23.40	$58.92	$88.38
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $48.93 / $48.93 / $88.38	Professional		$48.93	$48.93	$88.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.32 / $80.00 / $222.30	Facility		$35.32	$80.00	$222.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $39.74 / $65.95	Professional		$26.26	$39.74	$65.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.92 / $50.00 / $65.00	Professional		$17.92	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.40 / $58.92 / $88.38	Facility		$23.40	$58.92	$88.38
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $48.93 / $48.93 / $88.38	Professional		$48.93	$48.93	$88.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.15 / $10.25 / $13.31	Professional		$6.15	$10.25	$13.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $40.69 / $90.44 / $222.30	Facility		$40.69	$90.44	$222.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $31.00 / $41.50	Professional		$31.00	$31.00	$41.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.20 / $62.20 / $62.20	Professional		$62.20	$62.20	$62.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.20 / $62.20 / $62.20	Professional		$62.20	$62.20	$62.20
United Facility/Professional Professional Modifier Low / Median / High Price $25.11 / $37.32 / $64.89	Professional		$25.11	$37.32	$64.89