Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.87 / $21.87 / $48.77	Facility		$21.87	$21.87	$48.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.23 / $22.08 / $116.77	Professional		$21.23	$22.08	$116.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.28 / $45.64 / $47.34	Facility		$39.28	$45.64	$47.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.23 / $21.23 / $28.66	Professional		$21.23	$21.23	$28.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.07 / $29.07 / $33.97	Facility		$29.07	$29.07	$33.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.21 / $51.56 / $73.69	Facility		$28.21	$51.56	$73.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.29 / $36.20 / $41.14	Professional		$22.29	$36.20	$41.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.21 / $21.23 / $47.04	Facility		$19.21	$21.23	$47.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.16 / $14.16 / $14.16	Professional		$14.16	$14.16	$14.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.21 / $21.23 / $47.04	Facility		$19.21	$21.23	$47.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.23 / $21.23 / $31.85	Professional		$21.23	$21.23	$31.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.68 / $21.23 / $65.00	Professional		$19.68	$21.23	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.21 / $21.23 / $47.04	Facility		$19.21	$21.23	$47.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.16 / $14.16 / $14.16	Professional		$14.16	$14.16	$14.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.23 / $50.33 / $72.59	Professional		$21.23	$50.33	$72.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $113.14 / $113.14 / $113.14	Facility		$113.14	$113.14	$113.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.21 / $28.21 / $28.21	Professional		$28.21	$28.21	$28.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $29.81 / $41.96	Professional		$26.23	$29.81	$41.96
United Facility/Professional Professional Modifier Low / Median / High Price $21.23 / $21.23 / $31.85	Professional		$21.23	$21.23	$31.85