Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.71 / $13.71 / $13.71	Facility		$13.71	$13.71	$13.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.26 / $14.17 / $17.98	Professional		$13.26	$14.17	$17.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.61 / $23.61 / $38.96	Facility		$23.61	$23.61	$38.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.96 / $23.61 / $26.91	Professional		$21.96	$23.61	$26.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.61 / $50.53 / $50.53	Facility		$23.61	$50.53	$50.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.08 / $73.70 / $97.97	Facility		$63.08	$73.70	$97.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.63 / $34.22 / $44.69	Professional		$9.63	$34.22	$44.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.55 / $19.46 / $24.68	Facility		$13.55	$19.46	$24.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $23.61 / $23.61 / $25.38	Professional		$23.61	$23.61	$25.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.71 / $19.46 / $30.43	Facility		$13.71	$19.46	$30.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.89 / $13.35 / $85.61	Professional		$10.89	$13.35	$85.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.72 / $58.40 / $85.00	Professional		$13.72	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.55 / $19.46 / $24.68	Facility		$13.55	$19.46	$24.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $23.61 / $23.61 / $25.38	Professional		$23.61	$23.61	$25.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.61 / $35.42 / $62.00	Professional		$23.61	$35.42	$62.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $46.12 / $47.93 / $132.27	Facility		$46.12	$47.93	$132.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $9.63 / $103.77 / $305.66	Professional		$9.63	$103.77	$305.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.61 / $23.61 / $23.61	Professional		$23.61	$23.61	$23.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.61 / $23.61 / $23.61	Professional		$23.61	$23.61	$23.61
United Facility/Professional Professional Modifier Low / Median / High Price $8.35 / $11.78 / $21.87	Professional		$8.35	$11.78	$21.87