Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.18 / $21.18 / $21.18	Facility		$21.18	$21.18	$21.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.18 / $52.92 / $92.00	Professional		$21.18	$52.92	$92.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.47 / $36.47 / $60.18	Facility		$36.47	$36.47	$60.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $36.47 / $41.57	Professional		$33.92	$36.47	$41.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.47 / $78.05 / $78.05	Facility		$36.47	$78.05	$78.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.22 / $114.78 / $152.55	Facility		$98.22	$114.78	$152.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.88 / $52.97 / $69.04	Professional		$14.88	$52.97	$69.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.18 / $30.55 / $69.45	Facility		$21.18	$30.55	$69.45
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $36.47 / $38.22	Professional		$36.47	$36.47	$38.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.18 / $30.55 / $69.45	Facility		$21.18	$30.55	$69.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $20.62 / $95.40	Professional		$16.82	$20.62	$95.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $58.40 / $85.00	Professional		$21.20	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.18 / $30.55 / $69.45	Facility		$21.18	$30.55	$69.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $36.47 / $38.22	Professional		$36.47	$36.47	$38.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $54.71 / $96.00	Professional		$36.47	$54.71	$96.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $71.23 / $74.03 / $199.67	Facility		$71.23	$74.03	$199.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.88 / $160.29 / $461.14	Professional		$14.88	$160.29	$461.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $36.47 / $36.47	Professional		$36.47	$36.47	$36.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $36.47 / $64.45	Professional		$36.47	$36.47	$64.45
United Facility/Professional Professional Modifier Low / Median / High Price $15.33 / $18.20 / $30.33	Professional		$15.33	$18.20	$30.33