Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.13 / $64.36 / $365.59	Facility		$26.13	$64.36	$365.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $32.68 / $102.76	Professional		$25.37	$32.68	$102.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.71 / $31.71 / $31.71	Facility		$31.71	$31.71	$31.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $25.37 / $32.21	Professional		$25.37	$25.37	$32.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.74 / $34.74 / $40.59	Facility		$34.74	$34.74	$40.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.37 / $60.94 / $87.11	Facility		$25.37	$60.94	$87.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.01 / $42.28 / $48.05	Professional		$34.01	$42.28	$48.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.37 / $28.02 / $55.60	Facility		$25.37	$28.02	$55.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $42.03 / $50.74 / $50.74	Professional		$42.03	$50.74	$50.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.02 / $28.02 / $274.31	Facility		$28.02	$28.02	$274.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.02 / $28.02 / $50.74	Professional		$28.02	$28.02	$50.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $65.00 / $85.00	Professional		$33.40	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.37 / $28.02 / $55.60	Facility		$25.37	$28.02	$55.60
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $42.03 / $50.74 / $50.74	Professional		$42.03	$50.74	$50.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $39.47 / $103.00	Professional		$25.37	$39.47	$103.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $25.37 / $25.37 / $147.61	Facility		$25.37	$25.37	$147.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $25.37 / $25.37	Professional		$25.37	$25.37	$25.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $35.61 / $68.02	Professional		$35.61	$35.61	$68.02
United Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $25.37 / $39.38	Professional		$25.37	$25.37	$39.38