Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.77 / $17.77 / $17.77	Facility		$17.77	$17.77	$17.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.84 / $17.77 / $31.99	Professional		$16.84	$17.77	$31.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.22 / $38.75 / $64.12	Facility		$35.22	$38.75	$64.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.76 / $32.76 / $43.33	Professional		$32.76	$32.76	$43.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.34 / $75.39 / $75.39	Facility		$25.34	$75.39	$75.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.27 / $78.14 / $146.94	Facility		$24.27	$78.14	$146.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.72 / $51.09 / $66.66	Professional		$17.72	$51.09	$66.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.14 / $26.66 / $40.51	Facility		$10.14	$26.66	$40.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $20.18 / $34.40 / $42.28	Professional		$20.18	$34.40	$42.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.55 / $35.22 / $164.13	Facility		$17.55	$35.22	$164.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.40 / $18.45 / $38.36	Professional		$15.40	$18.45	$38.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.36 / $55.00 / $85.00	Professional		$17.36	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.14 / $26.66 / $40.51	Facility		$10.14	$26.66	$40.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $20.18 / $34.40 / $42.28	Professional		$20.18	$34.40	$42.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $54.22 / $94.35	Professional		$35.22	$54.22	$94.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $24.27 / $68.80 / $164.13	Facility		$24.27	$68.80	$164.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.72 / $24.27 / $177.29	Professional		$17.72	$24.27	$177.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $35.22 / $35.22	Professional		$35.22	$35.22	$35.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28.14 / $35.22 / $35.22	Professional		$28.14	$35.22	$35.22
United Facility/Professional Professional Modifier Low / Median / High Price $13.09 / $17.57 / $38.36	Professional		$13.09	$17.57	$38.36