Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.82 / $13.82 / $13.82	Facility		$13.82	$13.82	$13.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $13.82 / $20.42	Professional		$12.00	$13.82	$20.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.63 / $75.73 / $80.11	Facility		$62.63	$75.73	$80.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $25.00 / $27.00	Professional		$21.25	$25.00	$27.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.54 / $62.34 / $62.34	Facility		$20.54	$62.34	$62.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.22 / $94.62 / $146.94	Facility		$22.22	$94.62	$146.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $23.02 / $44.06	Professional		$16.22	$23.02	$44.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.00 / $23.30 / $33.50	Facility		$12.00	$23.30	$33.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $34.96 / $47.87	Professional		$29.13	$34.96	$47.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.82 / $29.13 / $159.28	Facility		$13.82	$29.13	$159.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.55 / $16.60 / $32.83	Professional		$12.55	$16.60	$32.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.00 / $23.30 / $33.50	Facility		$12.00	$23.30	$33.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $34.96 / $47.87	Professional		$29.13	$34.96	$47.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $55.06 / $90.33	Professional		$29.13	$55.06	$90.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $22.22 / $54.80 / $159.28	Facility		$22.22	$54.80	$159.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $22.22 / $158.43	Professional		$16.22	$22.22	$158.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $29.13 / $29.13	Professional		$29.13	$29.13	$29.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $21.42 / $29.13 / $29.13	Professional		$21.42	$29.13	$29.13
United Facility/Professional Professional Modifier Low / Median / High Price $11.31 / $14.24 / $27.30	Professional		$11.31	$14.24	$27.30