Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.32 / $19.32 / $19.32	Facility		$19.32	$19.32	$19.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.29 / $19.32 / $34.74	Professional		$18.29	$19.32	$34.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.31 / $42.14 / $69.72	Facility		$38.31	$42.14	$69.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $35.63 / $47.12	Professional		$34.47	$35.63	$47.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.55 / $81.98 / $81.98	Facility		$27.55	$81.98	$81.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $84.15 / $159.55	Facility		$21.38	$84.15	$159.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.61 / $55.31 / $72.50	Professional		$15.61	$55.31	$72.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $11.02 / $28.98 / $44.06	Facility		$11.02	$28.98	$44.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $37.36 / $45.97	Professional		$21.93	$37.36	$45.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.07 / $38.31 / $178.31	Facility		$19.07	$38.31	$178.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.73 / $20.07 / $41.71	Professional		$16.73	$20.07	$41.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $11.02 / $28.98 / $44.06	Facility		$11.02	$28.98	$44.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $37.36 / $45.97	Professional		$21.93	$37.36	$45.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $58.97 / $102.38	Professional		$38.31	$58.97	$102.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $74.81 / $178.31	Facility		$21.38	$74.81	$178.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.61 / $21.38 / $192.88	Professional		$15.61	$21.38	$192.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $38.31 / $38.31	Professional		$38.31	$38.31	$38.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.58 / $38.31 / $38.31	Professional		$30.58	$38.31	$38.31
United Facility/Professional Professional Modifier Low / Median / High Price $14.22 / $19.11 / $38.31	Professional		$14.22	$19.11	$38.31