Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.04 / $29.04 / $29.04	Facility		$29.04	$29.04	$29.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.46 / $29.04 / $51.38	Professional		$25.46	$29.04	$51.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.56 / $63.32 / $104.76	Facility		$57.56	$63.32	$104.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.53 / $53.53 / $70.79	Professional		$53.53	$53.53	$70.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.41 / $123.18 / $123.18	Facility		$41.41	$123.18	$123.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.97 / $119.13 / $240.73	Facility		$35.97	$119.13	$240.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $83.44 / $108.94	Professional		$26.26	$83.44	$108.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.54 / $43.56 / $66.19	Facility		$18.54	$43.56	$66.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $32.96 / $57.56 / $76.73	Professional		$32.96	$57.56	$76.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.04 / $57.51 / $306.17	Facility		$29.04	$57.51	$306.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.77 / $38.46 / $64.98	Professional		$26.77	$38.46	$64.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.94 / $58.40 / $85.00	Professional		$25.94	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.54 / $43.56 / $66.19	Facility		$18.54	$43.56	$66.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $32.96 / $57.56 / $76.73	Professional		$32.96	$57.56	$76.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.56 / $88.59 / $172.64	Professional		$57.56	$88.59	$172.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $35.97 / $112.42 / $306.17	Facility		$35.97	$112.42	$306.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $35.97 / $480.51	Professional		$26.26	$35.97	$480.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.56 / $57.56 / $57.56	Professional		$57.56	$57.56	$57.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.56 / $57.56 / $57.56	Professional		$57.56	$57.56	$57.56
United Facility/Professional Professional Modifier Low / Median / High Price $22.48 / $37.94 / $51.04	Professional		$22.48	$37.94	$51.04