Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.70 / $35.67 / $42.01	Facility		$18.70	$35.67	$42.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $18.70 / $31.42	Professional		$18.16	$18.70	$31.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.70 / $33.60 / $40.50	Facility		$22.70	$33.60	$40.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $18.16 / $23.06	Professional		$18.16	$18.16	$23.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.87 / $24.87 / $29.06	Facility		$24.87	$24.87	$29.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.16 / $41.91 / $59.90	Facility		$18.16	$41.91	$59.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $26.72 / $30.36	Professional		$18.16	$26.72	$30.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.16 / $18.29 / $39.93	Facility		$18.16	$18.29	$39.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $36.32 / $36.32	Professional		$27.44	$36.32	$36.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.29 / $18.29 / $40.64	Facility		$18.29	$18.29	$40.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.29 / $18.29 / $36.32	Professional		$18.29	$18.29	$36.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.34 / $65.00 / $85.00	Professional		$17.34	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.16 / $18.29 / $39.93	Facility		$18.16	$18.29	$39.93
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $36.32 / $36.32	Professional		$27.44	$36.32	$36.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $20.79 / $58.30	Professional		$18.16	$20.79	$58.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Facility		$86.70	$86.70	$86.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $18.16 / $18.16	Professional		$18.16	$18.16	$18.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.50 / $25.50 / $25.50	Professional		$25.50	$25.50	$25.50
United Facility/Professional Facility Modifier Low / Median / High Price $18.14 / $18.14 / $18.14	Facility		$18.14	$18.14	$18.14
United Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $18.16 / $24.86	Professional		$18.16	$18.16	$24.86