Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.38 / $55.61 / $65.52	Facility		$29.38	$55.61	$65.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $29.54 / $62.36	Professional		$28.68	$29.54	$62.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.85 / $53.06 / $63.96	Facility		$35.85	$53.06	$63.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $28.68 / $36.42	Professional		$28.68	$28.68	$36.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.27 / $39.27 / $45.89	Facility		$39.27	$39.27	$45.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.68 / $69.06 / $98.73	Facility		$28.68	$69.06	$98.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $43.03 / $48.90	Professional		$29.06	$43.03	$48.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.86 / $28.52 / $63.45	Facility		$21.86	$28.52	$63.45
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $57.36 / $57.36	Professional		$42.78	$57.36	$57.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.86 / $28.52 / $62.74	Facility		$21.86	$28.52	$62.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $57.36	Professional		$28.52	$28.52	$57.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.53 / $65.00 / $85.00	Professional		$28.53	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.86 / $28.52 / $63.45	Facility		$21.86	$28.52	$63.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $57.36 / $57.36	Professional		$42.78	$57.36	$57.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $41.07 / $88.00	Professional		$28.68	$41.07	$88.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $28.68 / $28.68 / $142.65	Facility		$28.68	$28.68	$142.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $28.68 / $28.68	Professional		$28.68	$28.68	$28.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.57 / $40.27 / $42.42	Professional		$29.57	$40.27	$42.42
United Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $28.68 / $39.27	Professional		$28.68	$28.68	$39.27