Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.61 / $28.61 / $28.61	Facility		$28.61	$28.61	$28.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.08 / $30.42 / $39.40	Professional		$27.08	$30.42	$39.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.71 / $62.38 / $103.21	Facility		$56.71	$62.38	$103.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.03 / $52.74 / $69.75	Professional		$51.03	$52.74	$69.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.79 / $121.36 / $121.36	Facility		$40.79	$121.36	$121.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.65 / $125.22 / $236.53	Facility		$31.65	$125.22	$236.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $82.03 / $107.33	Professional		$23.10	$82.03	$107.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $16.30 / $42.63 / $65.22	Facility		$16.30	$42.63	$65.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $55.34 / $68.05	Professional		$32.47	$55.34	$68.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.24 / $56.71 / $264.05	Facility		$28.24	$56.71	$264.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $29.71 / $61.75	Professional		$24.76	$29.71	$61.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $58.40 / $85.00	Professional		$30.93	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $16.30 / $42.92 / $65.22	Facility		$16.30	$42.92	$65.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $55.34 / $68.05	Professional		$32.47	$55.34	$68.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.71 / $87.29 / $151.56	Professional		$56.71	$87.29	$151.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $31.65 / $110.76 / $264.05	Facility		$31.65	$110.76	$264.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $31.65 / $285.55	Professional		$23.10	$31.65	$285.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.71 / $56.71 / $56.71	Professional		$56.71	$56.71	$56.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $45.29 / $56.71 / $56.71	Professional		$45.29	$56.71	$56.71
United Facility/Professional Facility Modifier Low / Median / High Price $0.04 / $25.04 / $29.48	Facility		$0.04	$25.04	$29.48
United Facility/Professional Professional Modifier Low / Median / High Price $22.60 / $29.48 / $50.28	Professional		$22.60	$29.48	$50.28