Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.72 / $64.11 / $165.49	Facility		$22.72	$64.11	$165.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $21.34 / $51.27	Professional		$20.72	$21.34	$51.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.90 / $25.90 / $25.90	Facility		$25.90	$25.90	$25.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $20.72 / $26.31	Professional		$20.72	$20.72	$26.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.37 / $28.37 / $33.15	Facility		$28.37	$28.37	$33.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.72 / $54.50 / $77.91	Facility		$20.72	$54.50	$77.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $30.57 / $34.74	Professional		$20.72	$30.57	$34.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.57 / $22.06 / $45.62	Facility		$14.57	$22.06	$45.62
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3.47 / $41.44 / $41.44	Professional		$3.47	$41.44	$41.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.57 / $22.06 / $105.66	Facility		$14.57	$22.06	$105.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.06 / $22.06 / $41.44	Professional		$22.06	$22.06	$41.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.29 / $65.00 / $85.00	Professional		$21.29	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.57 / $22.06 / $45.62	Facility		$14.57	$22.06	$45.62
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3.47 / $41.44 / $41.44	Professional		$3.47	$41.44	$41.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.71 / $25.75 / $67.00	Professional		$20.71	$25.75	$67.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $20.72 / $20.72 / $100.00	Facility		$20.72	$20.72	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $20.72 / $20.72	Professional		$20.72	$20.72	$20.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $19.72 / $29.09 / $29.09	Professional		$19.72	$29.09	$29.09
United Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $20.72 / $29.01	Professional		$20.72	$20.72	$29.01