Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.42 / $27.42 / $27.42	Facility		$27.42	$27.42	$27.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $27.42 / $27.42	Professional		$26.62	$27.42	$27.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $26.62 / $39.49	Professional		$26.62	$26.62	$39.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.45 / $36.45 / $42.59	Facility		$36.45	$36.45	$42.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.62 / $63.89 / $91.32	Facility		$26.62	$63.89	$91.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $27.62 / $33.52	Professional		$26.62	$27.62	$33.52
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.62 / $27.31 / $58.46	Facility		$26.62	$27.31	$58.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.31 / $27.31 / $59.88	Facility		$27.31	$27.31	$59.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.31 / $27.31 / $35.50	Professional		$27.31	$27.31	$35.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $55.00 / $85.00	Professional		$26.31	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.62 / $27.31 / $58.46	Facility		$26.62	$27.31	$58.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $34.90 / $97.90	Professional		$26.62	$34.90	$97.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $126.78 / $126.78 / $126.78	Facility		$126.78	$126.78	$126.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $26.62 / $26.62	Professional		$26.62	$26.62	$26.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $37.36 / $37.36 / $37.36	Professional		$37.36	$37.36	$37.36
United Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $26.62 / $36.45	Professional		$26.62	$26.62	$36.45