Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.75 / $24.75 / $24.75	Facility		$24.75	$24.75	$24.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.93 / $24.75 / $35.71	Professional		$19.93	$24.75	$35.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.64 / $42.64 / $70.36	Facility		$42.64	$42.64	$70.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $42.64 / $48.60	Professional		$39.65	$42.64	$48.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.64 / $91.25 / $91.25	Facility		$42.64	$91.25	$91.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.44 / $133.72 / $177.74	Facility		$114.44	$133.72	$177.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.39 / $61.88 / $80.70	Professional		$17.39	$61.88	$80.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.46 / $35.13 / $42.64	Facility		$24.46	$35.13	$42.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $34.74 / $34.74 / $42.64	Professional		$34.74	$34.74	$42.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.75 / $35.13 / $44.77	Facility		$24.75	$35.13	$44.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.67 / $24.10 / $117.34	Professional		$19.67	$24.10	$117.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.77 / $65.00 / $85.00	Professional		$24.77	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.46 / $35.13 / $42.64	Facility		$24.46	$35.13	$42.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $34.74 / $34.74 / $42.64	Professional		$34.74	$34.74	$42.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $63.96 / $112.00	Professional		$42.64	$63.96	$112.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.28 / $86.56 / $199.56	Facility		$83.28	$86.56	$199.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.39 / $187.38 / $418.74	Professional		$17.39	$187.38	$418.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $42.64 / $42.64	Professional		$42.64	$42.64	$42.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $42.64 / $58.54	Professional		$42.64	$42.64	$58.54
United Facility/Professional Professional Modifier Low / Median / High Price $17.92 / $21.27 / $39.47	Professional		$17.92	$21.27	$39.47