Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.65 / $13.65 / $13.65	Facility		$13.65	$13.65	$13.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.65 / $15.88 / $20.17	Professional		$13.65	$15.88	$20.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $39.11 / $45.47	Professional		$27.45	$39.11	$45.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.42 / $21.42 / $21.42	Facility		$21.42	$21.42	$21.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.60 / $81.00 / $113.36	Facility		$27.60	$81.00	$113.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $30.38 / $37.97	Professional		$20.14	$30.38	$37.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.16 / $20.48 / $29.71	Facility		$13.16	$20.48	$29.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $22.45 / $22.45	Professional		$22.45	$22.45	$22.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.65 / $29.71 / $141.59	Facility		$13.65	$29.71	$141.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.68 / $20.94 / $34.47	Professional		$15.68	$20.94	$34.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.08 / $55.00 / $85.00	Professional		$26.08	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.16 / $20.48 / $29.71	Facility		$13.16	$20.48	$29.71
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $22.45 / $22.45	Professional		$22.45	$22.45	$22.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.38 / $63.10 / $81.94	Professional		$34.38	$63.10	$81.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $27.60 / $50.96 / $141.59	Facility		$27.60	$50.96	$141.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $27.60 / $187.28	Professional		$20.14	$27.60	$187.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $37.74 / $38.51	Professional		$32.72	$37.74	$38.51
United Facility/Professional Professional Modifier Low / Median / High Price $12.44 / $17.70 / $30.73	Professional		$12.44	$17.70	$30.73