Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.97 / $15.97 / $15.97	Facility		$15.97	$15.97	$15.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.26 / $15.97 / $26.75	Professional		$13.26	$15.97	$26.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.66 / $34.83 / $57.62	Facility		$31.66	$34.83	$57.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.44 / $29.44 / $38.94	Professional		$29.44	$29.44	$38.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.78 / $67.75 / $67.75	Facility		$22.78	$67.75	$67.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.14 / $70.14 / $131.56	Facility		$25.14	$70.14	$131.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.37 / $46.67 / $59.93	Professional		$21.37	$46.67	$59.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $9.11 / $23.96 / $36.40	Facility		$9.11	$23.96	$36.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $18.13 / $30.88 / $37.99	Professional		$18.13	$30.88	$37.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.77 / $31.66 / $135.94	Facility		$15.77	$31.66	$135.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $21.15 / $34.47	Professional		$14.45	$21.15	$34.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.73 / $55.00 / $85.00	Professional		$16.73	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $9.11 / $23.96 / $36.40	Facility		$9.11	$23.96	$36.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $18.13 / $30.88 / $37.99	Professional		$18.13	$30.88	$37.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $48.74 / $84.31	Professional		$31.66	$48.74	$84.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $25.14 / $61.84 / $135.94	Facility		$25.14	$61.84	$135.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.37 / $25.14 / $159.66	Professional		$21.37	$25.14	$159.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $31.66 / $31.66	Professional		$31.66	$31.66	$31.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $31.66 / $31.66	Professional		$31.66	$31.66	$31.66
United Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $19.00 / $31.66	Professional		$12.62	$19.00	$31.66