Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.13 / $44.11 / $51.94	Facility		$22.13	$44.11	$51.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $22.13 / $69.59	Professional		$21.48	$22.13	$69.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.85 / $39.74 / $47.90	Facility		$26.85	$39.74	$47.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $21.48 / $27.27	Professional		$21.48	$21.48	$27.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.41 / $29.41 / $34.36	Facility		$29.41	$29.41	$34.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.48 / $56.65 / $80.97	Facility		$21.48	$56.65	$80.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.74 / $41.58 / $47.25	Professional		$23.74	$41.58	$47.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $20.53 / $22.62 / $48.48	Facility		$20.53	$22.62	$48.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $11.49 / $42.96 / $42.96	Professional		$11.49	$42.96	$42.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.53 / $22.62 / $49.90	Facility		$20.53	$22.62	$49.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.62 / $22.62 / $42.96	Professional		$22.62	$22.62	$42.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.31 / $65.00 / $85.00	Professional		$23.31	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $20.53 / $22.62 / $48.48	Facility		$20.53	$22.62	$48.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $11.49 / $42.96 / $42.96	Professional		$11.49	$42.96	$42.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $33.45 / $74.00	Professional		$21.48	$33.45	$74.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $132.80 / $132.80 / $132.80	Facility		$132.80	$132.80	$132.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $21.48 / $21.48	Professional		$21.48	$21.48	$21.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.62 / $22.62 / $22.62	Professional		$22.62	$22.62	$22.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $30.16 / $40.22	Professional		$27.74	$30.16	$40.22
United Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $21.48 / $34.36	Professional		$21.48	$21.48	$34.36