Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.68 / $38.68 / $38.68	Facility		$38.68	$38.68	$38.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $34.81 / $45.63	Professional		$24.31	$34.81	$45.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.40 / $104.47 / $104.47	Facility		$57.40	$104.47	$104.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $53.43 / $77.48	Professional		$53.38	$53.43	$77.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.42 / $33.21 / $122.94	Facility		$4.42	$33.21	$122.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.64 / $37.64 / $153.19	Facility		$37.64	$37.64	$153.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.64 / $66.75 / $83.44	Professional		$37.64	$66.75	$83.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.55 / $49.22 / $70.76	Facility		$19.55	$49.22	$70.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $40.89 / $73.84	Professional		$40.89	$40.89	$73.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.55 / $73.84 / $270.08	Facility		$19.55	$73.84	$270.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.67 / $34.71 / $73.55	Professional		$25.67	$34.71	$73.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.38 / $50.00 / $65.00	Professional		$20.38	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.55 / $49.22 / $70.76	Facility		$19.55	$49.22	$70.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $40.89 / $73.84	Professional		$40.89	$40.89	$73.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.58 / $14.20 / $18.44	Professional		$7.58	$14.20	$18.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $37.64 / $111.54 / $270.08	Facility		$37.64	$111.54	$270.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.64 / $37.64 / $45.15	Professional		$37.64	$37.64	$45.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.49 / $59.49 / $59.49	Professional		$59.49	$59.49	$59.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.49 / $59.49 / $59.49	Professional		$59.49	$59.49	$59.49
United Facility/Professional Professional Modifier Low / Median / High Price $22.31 / $34.04 / $69.40	Professional		$22.31	$34.04	$69.40