Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.17 / $48.01 / $162.65	Facility		$22.17	$48.01	$162.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $22.17 / $33.52	Professional		$21.53	$22.17	$33.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.91 / $26.91 / $26.91	Facility		$26.91	$26.91	$26.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $21.53 / $29.06	Professional		$21.53	$21.53	$29.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.45 / $38.75 / $39.46	Facility		$34.45	$38.75	$39.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.52 / $33.04 / $68.70	Facility		$21.52	$33.04	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $27.47 / $41.28	Professional		$21.52	$27.47	$41.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $20.90 / $22.17 / $107.37	Facility		$20.90	$22.17	$107.37
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $43.06 / $43.06	Professional		$25.12	$43.06	$43.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.90 / $21.53 / $107.37	Facility		$20.90	$21.53	$107.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.90 / $26.33 / $971.75	Professional		$20.90	$26.33	$971.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $20.90 / $22.17 / $107.37	Facility		$20.90	$22.17	$107.37
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $43.06 / $43.06	Professional		$25.12	$43.06	$43.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $33.40 / $65.00	Professional		$21.53	$33.40	$65.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $21.52 / $85.00 / $875.64	Facility		$21.52	$85.00	$875.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $39.99 / $971.75	Professional		$21.52	$39.99	$971.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.90 / $20.90 / $20.90	Professional		$20.90	$20.90	$20.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $30.23 / $45.51	Professional		$30.23	$30.23	$45.51
United Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $22.18 / $78.20	Professional		$21.53	$22.18	$78.20