Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.02 / $22.02 / $43.11	Facility		$22.02	$22.02	$43.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $25.22 / $45.86	Professional		$22.02	$25.22	$45.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.36 / $38.90 / $64.37	Facility		$35.36	$38.90	$64.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.89 / $35.36 / $43.50	Professional		$32.89	$35.36	$43.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.75 / $75.69 / $75.69	Facility		$47.75	$75.69	$75.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.15 / $136.96 / $169.35	Facility		$38.15	$136.96	$169.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.43 / $58.56 / $66.55	Professional		$32.43	$58.56	$66.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.10 / $33.69 / $42.44	Facility		$19.10	$33.69	$42.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $18.36 / $38.00 / $42.44	Professional		$18.36	$38.00	$42.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.02 / $42.44 / $181.21	Facility		$22.02	$42.44	$181.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.35 / $34.52 / $56.93	Professional		$27.35	$34.52	$56.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.71 / $55.00 / $85.00	Professional		$36.71	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.10 / $35.36 / $42.44	Facility		$19.10	$35.36	$42.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $18.36 / $38.00 / $42.44	Professional		$18.36	$38.00	$42.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $42.60 / $81.03	Professional		$35.36	$42.60	$81.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $38.15 / $68.68 / $181.21	Facility		$38.15	$68.68	$181.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.43 / $38.15 / $275.95	Professional		$32.43	$38.15	$275.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.02 / $54.02 / $54.02	Professional		$54.02	$54.02	$54.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $54.02 / $62.35	Professional		$53.00	$54.02	$62.35
United Facility/Professional Facility Modifier Low / Median / High Price $77.73 / $77.73 / $77.73	Facility		$77.73	$77.73	$77.73
United Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $33.11 / $55.43	Professional		$24.66	$33.11	$55.43