Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.94 / $34.94 / $34.94	Facility		$34.94	$34.94	$34.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $34.94 / $37.31	Professional		$33.92	$34.94	$37.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $33.92 / $54.27	Professional		$33.92	$33.92	$54.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.44 / $53.93 / $54.27	Facility		$46.44	$53.93	$54.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.42 / $83.08 / $117.76	Facility		$45.42	$83.08	$117.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $43.22 / $52.60	Professional		$33.92	$43.22	$52.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $34.94 / $53.46	Facility		$33.92	$34.94	$53.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $34.94 / $62.89	Facility		$33.92	$34.94	$62.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $33.92 / $54.27	Professional		$33.92	$33.92	$54.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $34.94 / $53.46	Facility		$33.92	$34.94	$53.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $33.92 / $52.58	Professional		$33.92	$33.92	$52.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $75.00 / $120.00	Facility		$33.92	$75.00	$120.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $46.40 / $112.00	Professional		$33.92	$46.40	$112.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.62 / $47.62 / $47.62	Professional		$47.62	$47.62	$47.62
United Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $33.92 / $42.74	Professional		$33.92	$33.92	$42.74