Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.69 / $24.08 / $28.37	Facility		$12.69	$24.08	$28.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $12.69 / $3,507.68	Professional		$12.32	$12.69	$3,507.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.40 / $22.79 / $27.47	Facility		$15.40	$22.79	$27.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $12.32 / $15.64	Professional		$12.32	$12.32	$15.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.87 / $16.87 / $19.71	Facility		$16.87	$16.87	$19.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.32 / $29.57 / $42.28	Facility		$12.32	$29.57	$42.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.53 / $18.92 / $21.50	Professional		$12.53	$18.92	$21.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.32 / $12.35 / $27.09	Facility		$12.32	$12.35	$27.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $18.53 / $24.64 / $24.64	Professional		$18.53	$24.64	$24.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.35 / $12.35 / $27.09	Facility		$12.35	$12.35	$27.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.35 / $12.35 / $24.64	Professional		$12.35	$12.35	$24.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.27 / $65.00 / $85.00	Professional		$12.27	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.32 / $12.35 / $27.09	Facility		$12.32	$12.35	$27.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $18.53 / $24.64 / $24.64	Professional		$18.53	$24.64	$24.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $19.02 / $41.06	Professional		$12.32	$19.02	$41.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Facility		$85.00	$85.00	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $12.32 / $12.32	Professional		$12.32	$12.32	$12.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $17.30 / $17.30	Professional		$17.30	$17.30	$17.30
United Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $12.32 / $16.02	Professional		$12.32	$12.32	$16.02