Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.34 / $31.34 / $31.34	Facility		$31.34	$31.34	$31.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.68 / $31.34 / $52.57	Professional		$27.68	$31.34	$52.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.13 / $68.34 / $113.08	Facility		$62.13	$68.34	$113.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.91 / $57.78 / $76.41	Professional		$55.91	$57.78	$76.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.69 / $132.96 / $132.96	Facility		$44.69	$132.96	$132.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.57 / $128.51 / $258.92	Facility		$38.57	$128.51	$258.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $103.47 / $117.58	Professional		$28.16	$103.47	$117.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.77 / $47.01 / $71.45	Facility		$18.77	$47.01	$71.45
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $35.59 / $62.13 / $76.88	Professional		$35.59	$62.13	$76.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.34 / $65.23 / $310.38	Facility		$31.34	$65.23	$310.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $33.93 / $70.18	Professional		$26.89	$33.93	$70.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $55.00 / $85.00	Professional		$26.78	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.77 / $47.01 / $71.45	Facility		$18.77	$47.01	$71.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $35.59 / $62.13 / $76.88	Professional		$35.59	$62.13	$76.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.13 / $95.61 / $174.64	Professional		$62.13	$95.61	$174.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $38.57 / $121.34 / $310.38	Facility		$38.57	$121.34	$310.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $38.57 / $384.66	Professional		$28.16	$38.57	$384.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.13 / $62.13 / $62.13	Professional		$62.13	$62.13	$62.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $49.63 / $62.13 / $62.13	Professional		$49.63	$62.13	$62.13
United Facility/Professional Facility Modifier Low / Median / High Price $0.05 / $30.63 / $33.65	Facility		$0.05	$30.63	$33.65
United Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $31.10 / $59.41	Professional		$22.77	$31.10	$59.41