Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.87 / $29.87 / $29.87	Facility		$29.87	$29.87	$29.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.87 / $40.20 / $120.00	Professional		$29.87	$40.20	$120.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.45 / $51.45 / $84.89	Facility		$51.45	$51.45	$84.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.85 / $51.45 / $58.65	Professional		$47.85	$51.45	$58.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.45 / $77.18 / $110.10	Facility		$51.45	$77.18	$110.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.02 / $61.74 / $119.29	Professional		$54.02	$61.74	$119.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.87 / $161.11 / $214.13	Facility		$137.87	$161.11	$214.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.99 / $74.53 / $97.36	Professional		$20.99	$74.53	$97.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.87 / $43.09 / $98.23	Facility		$29.87	$43.09	$98.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $51.45 / $60.93	Professional		$51.45	$51.45	$60.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.87 / $43.09 / $98.23	Facility		$29.87	$43.09	$98.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.74 / $28.30 / $65.19	Professional		$23.74	$28.30	$65.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $58.40 / $85.00	Professional		$29.89	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.87 / $43.09 / $98.23	Facility		$29.87	$43.09	$98.23
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $51.45 / $60.93	Professional		$51.45	$51.45	$60.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $77.18 / $135.00	Professional		$51.45	$77.18	$135.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.48 / $104.44 / $317.45	Facility		$100.48	$104.44	$317.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.99 / $226.08 / $731.46	Professional		$20.99	$226.08	$731.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $51.45 / $51.45	Professional		$51.45	$51.45	$51.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $51.45 / $102.48	Professional		$51.45	$51.45	$102.48
United Facility/Professional Professional Modifier Low / Median / High Price $21.81 / $25.66 / $49.19	Professional		$21.81	$25.66	$49.19