Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.54 / $54.97 / $54.97	Facility		$26.54	$54.97	$54.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $26.54 / $32.47	Professional		$25.77	$26.54	$32.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.67 / $55.41 / $57.47	Facility		$47.67	$55.41	$57.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $25.77 / $38.65	Professional		$25.77	$25.77	$38.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.93 / $35.54 / $47.23	Facility		$23.93	$35.54	$47.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.93 / $25.77 / $59.75	Professional		$23.93	$25.77	$59.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.77 / $35.88 / $65.64	Facility		$25.77	$35.88	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $30.87 / $38.13	Professional		$25.77	$30.87	$38.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.93 / $26.28 / $37.15	Facility		$23.93	$26.28	$37.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.93 / $24.17 / $34.51	Facility		$23.93	$24.17	$34.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.93 / $26.64 / $101.56	Professional		$23.93	$26.64	$101.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.93 / $58.40 / $85.00	Professional		$23.93	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.93 / $26.02 / $37.15	Facility		$23.93	$26.02	$37.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.45 / $30.52 / $79.64	Professional		$21.45	$30.52	$79.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $25.77 / $62.57 / $311.20	Facility		$25.77	$62.57	$311.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $62.57 / $101.56	Professional		$25.77	$62.57	$101.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.18 / $36.18 / $36.18	Professional		$36.18	$36.18	$36.18
United Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $27.32 / $32.47	Professional		$25.77	$27.32	$32.47