Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $19.95 / $21.88	Professional		$12.88	$19.95	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $56.23 / $56.23	Facility		$30.90	$56.23	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $30.90 / $41.69	Professional		$26.92	$30.90	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $123.03	Facility		$19.95	$19.95	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $41.69 / $58.88	Professional		$19.95	$41.69	$58.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $26.30 / $38.02	Facility		$10.47	$26.30	$38.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $20.89 / $20.89	Professional		$20.89	$20.89	$20.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $33.11 / $134.90	Facility		$10.47	$33.11	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $18.20 / $30.20	Professional		$13.49	$18.20	$30.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $50.12 / $64.57	Professional		$11.48	$50.12	$64.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.07 / $6.31 / $8.51	Professional		$4.07	$6.31	$8.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $60.26 / $134.90	Facility		$19.95	$60.26	$134.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $19.95 / $22.39	Professional		$16.98	$19.95	$22.39
United Facility/Professional Facility Modifier Low / Median / High Price $1.58 / $12.59 / $19.95	Facility		$1.58	$12.59	$19.95
United Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $17.78 / $33.11	Professional		$10.96	$17.78	$33.11