Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.74 / $24.74 / $24.74	Facility		$24.74	$24.74	$24.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.42 / $24.74 / $44.48	Professional		$23.42	$24.74	$44.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.04 / $53.94 / $89.25	Facility		$49.04	$53.94	$89.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.61 / $45.61 / $60.31	Professional		$45.61	$45.61	$60.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.29 / $104.95 / $104.95	Facility		$35.29	$104.95	$104.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.72 / $108.20 / $204.34	Facility		$33.72	$108.20	$204.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.62 / $71.25 / $92.81	Professional		$24.62	$71.25	$92.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.11 / $37.11 / $56.40	Facility		$14.11	$37.11	$56.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $28.09 / $47.87 / $58.85	Professional		$28.09	$47.87	$58.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.43 / $49.04 / $228.34	Facility		$24.43	$49.04	$228.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.42 / $25.69 / $53.40	Professional		$21.42	$25.69	$53.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.93 / $55.00 / $85.00	Professional		$28.93	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.11 / $37.11 / $56.40	Facility		$14.11	$37.11	$56.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $28.09 / $47.87 / $58.85	Professional		$28.09	$47.87	$58.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.04 / $75.48 / $131.47	Professional		$49.04	$75.48	$131.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $33.72 / $95.78 / $228.34	Facility		$33.72	$95.78	$228.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.62 / $33.72 / $246.66	Professional		$24.62	$33.72	$246.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $49.04 / $49.04 / $49.04	Professional		$49.04	$49.04	$49.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $39.18 / $49.04 / $49.04	Professional		$39.18	$49.04	$49.04
United Facility/Professional Facility Modifier Low / Median / High Price $70.09 / $70.09 / $70.09	Facility		$70.09	$70.09	$70.09
United Facility/Professional Professional Modifier Low / Median / High Price $18.22 / $24.47 / $43.48	Professional		$18.22	$24.47	$43.48