Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.93 / $25.93 / $25.93	Facility		$25.93	$25.93	$25.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.93 / $30.17 / $38.32	Professional		$25.93	$30.17	$38.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.79 / $49.79 / $86.37	Professional		$49.79	$49.79	$86.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.71 / $40.71 / $40.71	Facility		$40.71	$40.71	$40.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.68 / $154.00 / $215.53	Facility		$49.68	$154.00	$215.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.27 / $57.75 / $72.19	Professional		$36.27	$57.75	$72.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.22 / $38.90 / $56.46	Facility		$25.22	$38.90	$56.46
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $43.02 / $43.02	Professional		$43.02	$43.02	$43.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.93 / $56.46 / $269.04	Facility		$25.93	$56.46	$269.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.79 / $40.15 / $65.52	Professional		$29.79	$40.15	$65.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $89.77	Professional		$50.00	$58.40	$89.77
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.22 / $38.90 / $56.46	Facility		$25.22	$38.90	$56.46
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $43.02 / $43.02	Professional		$43.02	$43.02	$43.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.33 / $119.90 / $155.68	Professional		$65.33	$119.90	$155.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $49.68 / $96.84 / $269.04	Facility		$49.68	$96.84	$269.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.27 / $49.68 / $356.91	Professional		$36.27	$49.68	$356.91
United Facility/Professional Professional Modifier Low / Median / High Price $27.53 / $33.63 / $59.87	Professional		$27.53	$33.63	$59.87