Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.51 / $64.58 / $74.15	Facility		$27.51	$64.58	$74.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $27.51 / $33.39	Professional		$26.71	$27.51	$33.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.39 / $49.41 / $59.56	Facility		$33.39	$49.41	$59.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $26.71 / $36.04	Professional		$26.71	$26.71	$36.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.74 / $48.08 / $48.95	Facility		$42.74	$48.08	$48.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.71 / $43.10 / $89.60	Facility		$26.71	$43.10	$89.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $38.63 / $60.85	Professional		$26.71	$38.63	$60.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.71 / $29.38 / $68.47	Facility		$26.71	$29.38	$68.47
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $53.42 / $53.42	Professional		$48.44	$53.42	$53.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.29 / $33.25 / $68.47	Facility		$32.29	$33.25	$68.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $35.95 / $1,801.12	Professional		$32.29	$35.95	$1,801.12
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 $26.71 / $29.73 / $68.47	Facility		$26.71	$29.73	$68.47
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $53.42 / $53.42	Professional		$48.44	$53.42	$53.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $41.58 / $103.34	Professional		$26.71	$41.58	$103.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26.71 / $85.00 / $224.95	Facility		$26.71	$85.00	$224.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $54.31 / $1,801.12	Professional		$26.71	$54.31	$1,801.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $37.50 / $103.68	Professional		$37.50	$37.50	$103.68
United Facility/Professional Facility Modifier Low / Median / High Price $30.32 / $30.32 / $65.19	Facility		$30.32	$30.32	$65.19
United Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $27.51 / $33.65	Professional		$26.71	$27.51	$33.65