Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.77 / $39.77 / $39.77	Facility		$39.77	$39.77	$39.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.99 / $35.79 / $46.92	Professional		$24.99	$35.79	$46.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.90 / $107.20 / $107.20	Facility		$58.90	$107.20	$107.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.78 / $54.80 / $79.51	Professional		$54.78	$54.80	$79.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.62 / $34.36 / $126.09	Facility		$4.62	$34.36	$126.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.63 / $38.63 / $157.69	Facility		$38.63	$38.63	$157.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.63 / $68.25 / $85.31	Professional		$38.63	$68.25	$85.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $20.23 / $50.98 / $73.28	Facility		$20.23	$50.98	$73.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $42.34 / $76.45	Professional		$42.34	$42.34	$76.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.23 / $76.45 / $277.14	Facility		$20.23	$76.45	$277.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.57 / $35.79 / $75.63	Professional		$26.57	$35.79	$75.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.11 / $50.00 / $65.00	Professional		$21.11	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $20.23 / $50.98 / $73.28	Facility		$20.23	$50.98	$73.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $42.34 / $76.45	Professional		$42.34	$42.34	$76.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.77 / $14.20 / $18.44	Professional		$7.77	$14.20	$18.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $38.63 / $114.40 / $277.14	Facility		$38.63	$114.40	$277.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.63 / $38.63 / $46.31	Professional		$38.63	$38.63	$46.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $61.32 / $61.32	Professional		$61.32	$61.32	$61.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $61.32 / $61.32	Professional		$61.32	$61.32	$61.32
United Facility/Professional Professional Modifier Low / Median / High Price $25.39 / $35.24 / $61.32	Professional		$25.39	$35.24	$61.32