Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.64 / $21.64 / $21.64	Facility		$21.64	$21.64	$21.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.49 / $21.64 / $38.90	Professional		$20.49	$21.64	$38.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.90 / $47.19 / $78.08	Facility		$42.90	$47.19	$78.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.10 / $39.90 / $52.76	Professional		$37.10	$39.90	$52.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.86 / $91.81 / $91.81	Facility		$30.86	$91.81	$91.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.67 / $95.17 / $179.14	Facility		$26.67	$95.17	$179.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.47 / $62.34 / $81.19	Professional		$19.47	$62.34	$81.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.34 / $32.46 / $49.34	Facility		$12.34	$32.46	$49.34
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.57 / $41.88 / $51.48	Professional		$24.57	$41.88	$51.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.37 / $42.90 / $199.79	Facility		$21.37	$42.90	$199.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $22.47 / $46.71	Professional		$18.73	$22.47	$46.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.67 / $55.00 / $85.00	Professional		$20.67	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.34 / $32.46 / $49.34	Facility		$12.34	$32.46	$49.34
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.57 / $41.88 / $51.48	Professional		$24.57	$41.88	$51.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.90 / $66.03 / $114.42	Professional		$42.90	$66.03	$114.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26.67 / $83.78 / $199.79	Facility		$26.67	$83.78	$199.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.47 / $26.67 / $215.93	Professional		$19.47	$26.67	$215.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.90 / $42.90 / $42.90	Professional		$42.90	$42.90	$42.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $34.26 / $42.90 / $42.90	Professional		$34.26	$42.90	$42.90
United Facility/Professional Professional Modifier Low / Median / High Price $14.97 / $21.40 / $40.88	Professional		$14.97	$21.40	$40.88