Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.57 / $50.49 / $50.49	Facility		$19.57	$50.49	$50.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $19.57 / $26.61	Professional		$19.00	$19.57	$26.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $40.85 / $42.37	Facility		$35.15	$40.85	$42.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $19.00 / $28.50	Professional		$19.00	$19.00	$28.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.01 / $28.12 / $30.40	Facility		$26.01	$28.12	$30.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.00 / $45.71 / $95.03	Facility		$19.00	$45.71	$95.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $36.61 / $69.01	Professional		$19.00	$36.61	$69.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.00 / $19.76 / $39.32	Facility		$19.00	$19.76	$39.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.99 / $22.20 / $33.86	Facility		$21.99	$22.20	$33.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.99 / $24.48 / $126.91	Professional		$21.99	$24.48	$126.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $50.30 / $85.00	Professional		$19.00	$50.30	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.00 / $19.76 / $28.50	Facility		$19.00	$19.76	$28.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.14 / $32.15 / $91.98	Professional		$14.14	$32.15	$91.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $19.00 / $90.07 / $461.50	Facility		$19.00	$90.07	$461.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $92.30 / $126.91	Professional		$19.00	$92.30	$126.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $26.68 / $26.68 / $26.68	Professional		$26.68	$26.68	$26.68
United Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $19.95 / $23.94	Professional		$19.00	$19.95	$23.94