Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.90 / $29.90 / $29.90	Facility		$29.90	$29.90	$29.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.09 / $26.26 / $33.97	Professional		$18.09	$26.26	$33.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.10 / $80.26 / $80.26	Facility		$44.10	$80.26	$80.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.98 / $41.01 / $59.48	Professional		$40.98	$41.01	$59.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.50 / $26.23 / $94.29	Facility		$3.50	$26.23	$94.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.79 / $27.79 / $113.54	Facility		$27.79	$27.79	$113.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $49.50 / $61.88	Professional		$27.79	$49.50	$61.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.31 / $37.42 / $55.94	Facility		$13.31	$37.42	$55.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $26.78 / $58.37	Professional		$26.78	$26.78	$58.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.31 / $55.94 / $199.27	Facility		$13.31	$55.94	$199.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.83 / $53.03	Professional		$19.05	$23.83	$53.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.89 / $50.00 / $65.00	Professional		$13.89	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.31 / $38.90 / $55.94	Facility		$13.31	$38.90	$55.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $26.78 / $58.37	Professional		$26.78	$26.78	$58.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.82 / $9.47 / $12.29	Professional		$5.82	$9.47	$12.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $27.79 / $85.54 / $199.27	Facility		$27.79	$85.54	$199.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $27.79 / $32.86	Professional		$27.79	$27.79	$32.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $47.51 / $47.51	Professional		$47.51	$47.51	$47.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $47.51 / $47.51	Professional		$47.51	$47.51	$47.51
United Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $23.56 / $50.48	Professional		$16.82	$23.56	$50.48