Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.52 / $36.95 / $43.53	Facility		$19.52	$36.95	$43.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.01 / $22.68 / $32.56	Professional		$22.01	$22.68	$32.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.53 / $40.74 / $49.10	Facility		$27.53	$40.74	$49.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $22.02 / $27.96	Professional		$22.02	$22.02	$27.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.15 / $30.15 / $35.22	Facility		$30.15	$30.15	$35.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.02 / $51.11 / $73.06	Facility		$22.02	$51.11	$73.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.86 / $29.41 / $33.43	Professional		$21.86	$29.41	$33.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.95 / $18.95 / $48.48	Facility		$18.95	$18.95	$48.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $28.43 / $44.04 / $44.04	Professional		$28.43	$44.04	$44.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.95 / $18.95 / $42.05	Facility		$18.95	$18.95	$42.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.95 / $18.95 / $42.14	Professional		$18.95	$18.95	$42.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.83 / $20.83 / $85.00	Professional		$20.83	$20.83	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.95 / $18.95 / $48.48	Facility		$18.95	$18.95	$48.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $28.43 / $44.04 / $44.04	Professional		$28.43	$44.04	$44.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $32.28 / $70.40	Professional		$22.02	$32.28	$70.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $104.15 / $104.15 / $104.15	Facility		$104.15	$104.15	$104.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $22.02 / $22.02	Professional		$22.02	$22.02	$22.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.92 / $30.92 / $30.92	Professional		$30.92	$30.92	$30.92
United Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $22.02 / $33.03	Professional		$22.02	$22.02	$33.03