Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.04 / $24.04 / $24.04	Facility		$24.04	$24.04	$24.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.85 / $24.04 / $40.06	Professional		$19.85	$24.04	$40.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.66 / $52.43 / $86.74	Facility		$47.66	$52.43	$86.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.89 / $44.32 / $58.62	Professional		$42.89	$44.32	$58.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.28 / $101.99 / $101.99	Facility		$34.28	$101.99	$101.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.78 / $98.51 / $198.74	Facility		$29.78	$98.51	$198.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $68.91 / $90.20	Professional		$21.74	$68.91	$90.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.35 / $36.06 / $54.81	Facility		$15.35	$36.06	$54.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $27.29 / $47.66 / $63.54	Professional		$27.29	$47.66	$63.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.04 / $47.53 / $253.42	Facility		$24.04	$47.53	$253.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.16 / $31.84 / $53.80	Professional		$22.16	$31.84	$53.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.81 / $55.00 / $85.00	Professional		$10.81	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $15.35 / $36.06 / $54.81	Facility		$15.35	$36.06	$54.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $27.29 / $47.66 / $63.54	Professional		$27.29	$47.66	$63.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.66 / $73.33 / $142.53	Professional		$47.66	$73.33	$142.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $29.78 / $93.08 / $253.42	Facility		$29.78	$93.08	$253.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $29.78 / $432.68	Professional		$21.74	$29.78	$432.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.66 / $47.66 / $47.66	Professional		$47.66	$47.66	$47.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.66 / $47.66 / $47.66	Professional		$47.66	$47.66	$47.66
United Facility/Professional Professional Modifier Low / Median / High Price $18.98 / $31.70 / $47.66	Professional		$18.98	$31.70	$47.66