Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.03 / $26.03 / $26.03	Facility		$26.03	$26.03	$26.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.36 / $23.43 / $29.39	Professional		$16.36	$23.43	$29.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.90 / $68.98 / $68.98	Facility		$37.90	$68.98	$68.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.19 / $35.25 / $51.08	Professional		$35.19	$35.25	$51.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.15 / $23.66 / $80.98	Facility		$3.15	$23.66	$80.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.94 / $24.94 / $100.93	Facility		$24.94	$24.94	$100.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.94 / $43.88 / $54.84	Professional		$24.94	$43.88	$54.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.94 / $35.10 / $50.45	Facility		$13.94	$35.10	$50.45
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $29.14 / $52.64	Professional		$29.14	$29.14	$52.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.94 / $52.64 / $177.61	Facility		$13.94	$52.64	$177.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.29 / $24.26 / $48.66	Professional		$18.29	$24.26	$48.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.53 / $50.00 / $65.00	Professional		$14.53	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.94 / $35.10 / $50.45	Facility		$13.94	$35.10	$50.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $29.14 / $52.64	Professional		$29.14	$29.14	$52.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $8.68 / $11.27	Professional		$5.00	$8.68	$11.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $24.94 / $73.48 / $177.61	Facility		$24.94	$73.48	$177.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.94 / $24.94 / $29.73	Professional		$24.94	$24.94	$29.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $40.86 / $40.86	Professional		$40.86	$40.86	$40.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $40.86 / $40.86	Professional		$40.86	$40.86	$40.86
United Facility/Professional Professional Modifier Low / Median / High Price $14.97 / $23.66 / $46.32	Professional		$14.97	$23.66	$46.32