Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.32 / $24.32 / $24.32	Facility		$24.32	$24.32	$24.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.40 / $24.32 / $35.09	Professional		$13.40	$24.32	$35.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.89 / $41.89 / $69.12	Facility		$41.89	$41.89	$69.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.96 / $41.89 / $47.75	Professional		$38.96	$41.89	$47.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.89 / $89.64 / $89.64	Facility		$41.89	$89.64	$89.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.64 / $131.63 / $174.95	Facility		$112.64	$131.63	$174.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.09 / $60.94 / $79.29	Professional		$17.09	$60.94	$79.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.52 / $34.04 / $41.89	Facility		$23.52	$34.04	$41.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $22.45 / $41.89	Professional		$22.45	$22.45	$41.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.90 / $34.52 / $43.98	Facility		$23.90	$34.52	$43.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.32 / $23.03 / $76.04	Professional		$19.32	$23.03	$76.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $58.40 / $85.00	Professional		$24.33	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.52 / $34.52 / $41.89	Facility		$23.52	$34.52	$41.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $22.45 / $41.89	Professional		$22.45	$22.45	$41.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.89 / $62.84 / $110.00	Professional		$41.89	$62.84	$110.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $81.81 / $85.04 / $196.05	Facility		$81.81	$85.04	$196.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.09 / $184.10 / $272.08	Professional		$17.09	$184.10	$272.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.89 / $41.89 / $41.89	Professional		$41.89	$41.89	$41.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.89 / $41.89 / $41.89	Professional		$41.89	$41.89	$41.89
United Facility/Professional Professional Modifier Low / Median / High Price $17.60 / $20.90 / $38.79	Professional		$17.60	$20.90	$38.79