Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.96 / $47.00 / $53.97	Facility		$25.96	$47.00	$53.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $25.96 / $34.60	Professional		$25.20	$25.96	$34.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.50 / $31.50 / $31.50	Facility		$31.50	$31.50	$31.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $25.20 / $34.02	Professional		$25.20	$25.20	$34.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.32 / $45.36 / $46.19	Facility		$40.32	$45.36	$46.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.20 / $37.90 / $69.31	Facility		$25.20	$37.90	$69.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $31.36 / $52.53	Professional		$25.20	$31.36	$52.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.50 / $25.71 / $55.60	Facility		$23.50	$25.71	$55.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $50.40 / $50.40	Professional		$24.85	$50.40	$50.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.50 / $23.73 / $52.03	Facility		$23.50	$23.73	$52.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $26.16 / $565.38	Professional		$23.50	$26.16	$565.38
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 $23.50 / $25.46 / $55.60	Facility		$23.50	$25.46	$55.60
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $50.40 / $50.40	Professional		$24.85	$50.40	$50.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $38.15 / $77.00	Professional		$25.20	$38.15	$77.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $25.20 / $25.20 / $866.62	Facility		$25.20	$25.20	$866.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $46.12 / $565.38	Professional		$25.20	$46.12	$565.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $23.50 / $23.50	Professional		$23.50	$23.50	$23.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28.63 / $35.38 / $40.25	Professional		$28.63	$35.38	$40.25
United Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $25.96 / $35.28	Professional		$25.20	$25.96	$35.28