Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.44 / $44.44 / $44.44	Facility		$44.44	$44.44	$44.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.93 / $40.00 / $52.43	Professional		$27.93	$40.00	$52.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $121.76 / $121.76	Facility		$66.90	$121.76	$121.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $62.22 / $90.24	Professional		$62.17	$62.22	$90.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5.05 / $36.79 / $143.06	Facility		$5.05	$36.79	$143.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.42 / $44.42 / $178.42	Facility		$44.42	$44.42	$178.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.42 / $77.63 / $97.03	Professional		$44.42	$77.63	$97.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.66 / $54.55 / $79.98	Facility		$21.66	$54.55	$79.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $45.30 / $45.30 / $81.83	Professional		$45.30	$45.30	$81.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.66 / $81.83 / $317.39	Facility		$21.66	$81.83	$317.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.44 / $37.71 / $75.94	Professional		$28.44	$37.71	$75.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.13 / $50.00 / $65.00	Professional		$25.13	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.66 / $54.55 / $79.98	Facility		$21.66	$54.55	$79.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $45.30 / $45.30 / $81.83	Professional		$45.30	$45.30	$81.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.83 / $14.20 / $18.44	Professional		$8.83	$14.20	$18.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $44.42 / $129.82 / $317.39	Facility		$44.42	$129.82	$317.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.42 / $44.42 / $52.54	Professional		$44.42	$44.42	$52.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $67.52 / $67.52 / $67.52	Professional		$67.52	$67.52	$67.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $67.52 / $67.52 / $67.52	Professional		$67.52	$67.52	$67.52
United Facility/Professional Professional Modifier Low / Median / High Price $27.17 / $40.51 / $67.52	Professional		$27.17	$40.51	$67.52