Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.17 / $57.40 / $65.92	Facility		$30.17	$57.40	$65.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $30.17 / $40.22	Professional		$29.29	$30.17	$40.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.61 / $54.19 / $65.31	Facility		$36.61	$54.19	$65.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $29.29 / $39.54	Professional		$29.29	$29.29	$39.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.86 / $52.72 / $53.69	Facility		$46.86	$52.72	$53.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.29 / $37.78 / $78.54	Facility		$29.29	$37.78	$78.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $35.09 / $53.91	Professional		$29.29	$35.09	$53.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.70 / $29.59 / $32.90	Facility		$28.70	$29.59	$32.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $43.05 / $58.58 / $58.58	Professional		$43.05	$58.58	$58.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.70 / $28.70 / $31.88	Facility		$28.70	$28.70	$31.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $31.95 / $124.53	Professional		$28.70	$31.95	$124.53
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 $28.70 / $29.29 / $32.39	Facility		$28.70	$29.29	$32.39
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $43.05 / $58.58 / $58.58	Professional		$43.05	$58.58	$58.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $37.39 / $95.70	Professional		$29.29	$37.39	$95.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $29.29 / $29.29 / $144.60	Facility		$29.29	$29.29	$144.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $51.89 / $124.53	Professional		$29.29	$51.89	$124.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.81 / $41.12 / $41.12	Professional		$40.81	$41.12	$41.12
United Facility/Professional Facility Modifier Low / Median / High Price $29.29 / $29.29 / $29.29	Facility		$29.29	$29.29	$29.29
United Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $30.17 / $37.06	Professional		$29.29	$30.17	$37.06