Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.26 / $19.26 / $19.26	Facility		$19.26	$19.26	$19.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.93 / $19.91 / $83.00	Professional		$15.93	$19.91	$83.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.18 / $33.18 / $54.75	Facility		$33.18	$33.18	$54.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $33.18 / $37.82	Professional		$30.86	$33.18	$37.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.18 / $71.01 / $71.01	Facility		$33.18	$71.01	$71.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.21 / $104.25 / $138.56	Facility		$89.21	$104.25	$138.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $48.28 / $62.79	Professional		$13.54	$48.28	$62.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.03 / $27.33 / $33.39	Facility		$19.03	$27.33	$33.39
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $27.79 / $33.18	Professional		$27.79	$27.79	$33.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.26 / $27.33 / $34.84	Facility		$19.26	$27.33	$34.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.31 / $18.25 / $42.04	Professional		$15.31	$18.25	$42.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.28 / $58.40 / $85.00	Professional		$19.28	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.03 / $27.33 / $33.39	Facility		$19.03	$27.33	$33.39
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $27.79 / $33.18	Professional		$27.79	$27.79	$33.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.18 / $49.77 / $87.00	Professional		$33.18	$49.77	$87.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.80 / $67.36 / $155.28	Facility		$64.80	$67.36	$155.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $145.80 / $335.71	Professional		$13.54	$145.80	$335.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $33.18 / $33.18 / $33.18	Professional		$33.18	$33.18	$33.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $33.18 / $33.18 / $46.90	Professional		$33.18	$33.18	$46.90
United Facility/Professional Professional Modifier Low / Median / High Price $11.72 / $16.55 / $27.58	Professional		$11.72	$16.55	$27.58