Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.40 / $36.40 / $36.40	Facility		$36.40	$36.40	$36.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.88 / $32.19 / $38.84	Professional		$22.88	$32.19	$38.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.70 / $94.09 / $94.09	Facility		$51.70	$94.09	$94.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $50.27 / $69.79	Professional		$48.08	$50.27	$69.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.73 / $31.30 / $115.67	Facility		$3.73	$31.30	$115.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.20 / $25.20 / $144.18	Facility		$25.20	$25.20	$144.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $62.63 / $78.28	Professional		$25.20	$62.63	$78.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.42 / $46.40 / $66.70	Facility		$18.42	$46.40	$66.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $38.53 / $38.53 / $69.59	Professional		$38.53	$38.53	$69.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.42 / $65.54 / $258.33	Facility		$18.42	$65.54	$258.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $32.07 / $64.59	Professional		$24.18	$32.07	$64.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.21 / $50.00 / $65.00	Professional		$19.21	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.42 / $46.40 / $66.70	Facility		$18.42	$46.40	$66.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $38.53 / $38.53 / $69.59	Professional		$38.53	$38.53	$69.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.82 / $10.25 / $13.31	Professional		$6.82	$10.25	$13.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $25.20 / $104.94 / $258.33	Facility		$25.20	$104.94	$258.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $25.20 / $42.48	Professional		$25.20	$25.20	$42.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $56.02 / $56.02	Professional		$56.02	$56.02	$56.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $56.02 / $56.02	Professional		$56.02	$56.02	$56.02
United Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $31.28 / $65.31	Professional		$19.79	$31.28	$65.31