Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7.41 / $35.34 / $115.80	Facility		$7.41	$35.34	$115.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $18.71 / $60.94	Professional		$18.17	$18.71	$60.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.71 / $22.71 / $22.71	Facility		$22.71	$22.71	$22.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $18.17 / $23.07	Professional		$18.17	$18.17	$23.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.88 / $24.88 / $29.07	Facility		$24.88	$24.88	$29.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.17 / $44.59 / $63.73	Facility		$18.17	$44.59	$63.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $30.05 / $34.15	Professional		$17.00	$30.05	$34.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.25 / $17.67 / $39.93	Facility		$12.25	$17.67	$39.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $36.34 / $45.70	Professional		$26.51	$36.34	$45.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.25 / $17.67 / $88.83	Facility		$12.25	$17.67	$88.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.67 / $17.67 / $36.34	Professional		$17.67	$17.67	$36.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $65.00 / $85.00	Professional		$16.20	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.25 / $17.67 / $39.93	Facility		$12.25	$17.67	$39.93
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $36.34 / $45.70	Professional		$26.51	$36.34	$45.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $24.67 / $56.19	Professional		$18.17	$24.67	$56.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $128.49 / $128.49 / $128.49	Facility		$128.49	$128.49	$128.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $18.17 / $18.17	Professional		$18.17	$18.17	$18.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $16.79 / $25.51 / $25.51	Professional		$16.79	$25.51	$25.51
United Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $18.17 / $27.26	Professional		$18.17	$18.17	$27.26