Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.29 / $26.29 / $26.29	Facility		$26.29	$26.29	$26.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $27.94 / $41.52	Professional		$24.86	$27.94	$41.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.12 / $57.33 / $94.86	Facility		$52.12	$57.33	$94.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.07 / $48.47 / $64.09	Professional		$45.07	$48.47	$64.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.50 / $111.54 / $111.54	Facility		$37.50	$111.54	$111.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.89 / $115.20 / $216.93	Facility		$34.89	$115.20	$216.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.47 / $75.47 / $98.65	Professional		$25.47	$75.47	$98.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.99 / $39.44 / $59.94	Facility		$14.99	$39.44	$59.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $29.84 / $50.84 / $62.54	Professional		$29.84	$50.84	$62.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.94 / $52.12 / $242.56	Facility		$25.94	$52.12	$242.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.74 / $27.30 / $56.75	Professional		$22.74	$27.30	$56.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.82 / $55.00 / $85.00	Professional		$20.82	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.99 / $39.44 / $59.94	Facility		$14.99	$39.44	$59.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $29.84 / $50.84 / $62.54	Professional		$29.84	$50.84	$62.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $80.22 / $139.51	Professional		$52.12	$80.22	$139.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $34.89 / $101.80 / $242.56	Facility		$34.89	$101.80	$242.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.47 / $34.89 / $262.20	Professional		$25.47	$34.89	$262.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $52.12 / $52.12	Professional		$52.12	$52.12	$52.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.62 / $52.12 / $52.12	Professional		$41.62	$52.12	$52.12
United Facility/Professional Professional Modifier Low / Median / High Price $18.18 / $26.00 / $52.12	Professional		$18.18	$26.00	$52.12