Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.53 / $33.78 / $25,912.61	Facility		$17.53	$33.78	$25,912.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.02 / $17.53 / $6,062.70	Professional		$17.02	$17.53	$6,062.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.28 / $31.49 / $37.95	Facility		$21.28	$31.49	$37.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.02 / $17.02 / $22.97	Professional		$17.02	$17.02	$22.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.89 / $23.65 / $31.20	Facility		$16.89	$23.65	$31.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $17.02 / $39.46	Professional		$16.89	$17.02	$39.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.02 / $24.52 / $44.85	Facility		$17.02	$24.52	$44.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.02 / $20.67 / $30.30	Professional		$17.02	$20.67	$30.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.43 / $17.02 / $29.52	Facility		$14.43	$17.02	$29.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $25.34 / $34.04 / $34.04	Professional		$25.34	$34.04	$34.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.43 / $16.89 / $31.08	Facility		$14.43	$16.89	$31.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $18.80 / $4,929.21	Professional		$16.89	$18.80	$4,929.21
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 $14.43 / $17.02 / $29.52	Facility		$14.43	$17.02	$29.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $25.34 / $34.04 / $34.04	Professional		$25.34	$34.04	$34.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.01 / $22.53 / $50.00	Professional		$17.01	$22.53	$50.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $17.02 / $17.02 / $85.00	Facility		$17.02	$17.02	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.02 / $29.78 / $4,929.21	Professional		$17.02	$29.78	$4,929.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $15.25 / $23.90 / $23.90	Professional		$15.25	$23.90	$23.90
United Facility/Professional Professional Modifier Low / Median / High Price $17.02 / $17.53 / $20.25	Professional		$17.02	$17.53	$20.25