Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.49 / $25.49 / $25.49	Facility		$25.49	$25.49	$25.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.65 / $26.34 / $43.02	Professional		$24.65	$26.34	$43.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.90 / $43.90 / $72.44	Facility		$43.90	$43.90	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.83 / $43.90 / $50.04	Professional		$40.83	$43.90	$50.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.90 / $93.95 / $93.95	Facility		$43.90	$93.95	$93.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.05 / $137.94 / $183.34	Facility		$118.05	$137.94	$183.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.91 / $63.75 / $83.09	Professional		$17.91	$63.75	$83.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.19 / $36.17 / $43.90	Facility		$25.19	$36.17	$43.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $32.60 / $32.60 / $43.90	Professional		$32.60	$32.60	$43.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.19 / $36.17 / $46.10	Facility		$25.19	$36.17	$46.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.25 / $24.82 / $110.29	Professional		$20.25	$24.82	$110.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.50 / $58.40 / $85.00	Professional		$25.50	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.19 / $36.17 / $43.90	Facility		$25.19	$36.17	$43.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $32.60 / $32.60 / $43.90	Professional		$32.60	$32.60	$43.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.90 / $65.84 / $115.00	Professional		$43.90	$65.84	$115.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $85.74 / $89.12 / $205.45	Facility		$85.74	$89.12	$205.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.91 / $192.92 / $394.00	Professional		$17.91	$192.92	$394.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $43.90 / $43.90 / $43.90	Professional		$43.90	$43.90	$43.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.93 / $43.90 / $43.90	Professional		$29.93	$43.90	$43.90
United Facility/Professional Professional Modifier Low / Median / High Price $18.44 / $23.37 / $41.98	Professional		$18.44	$23.37	$41.98