Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $68.70 / $68.70	Facility		$27.30	$68.70	$68.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $27.30 / $33.40	Professional		$26.51	$27.30	$33.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.04 / $57.00 / $59.12	Facility		$49.04	$57.00	$59.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $26.51 / $39.76	Professional		$26.51	$26.51	$39.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.22 / $42.42 / $48.60	Facility		$39.22	$42.42	$48.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $51.72 / $107.52	Facility		$26.51	$51.72	$107.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $37.42 / $73.41	Professional		$26.51	$37.42	$73.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $27.57 / $45.21	Facility		$26.51	$27.57	$45.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.92 / $30.22 / $45.21	Facility		$29.92	$30.22	$45.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.92 / $33.31 / $253.17	Professional		$29.92	$33.31	$253.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $58.40 / $85.00	Professional		$26.51	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $27.57 / $39.77	Facility		$26.51	$27.57	$39.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.08 / $49.00 / $129.46	Professional		$22.08	$49.00	$129.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $73.12 / $165.45	Facility		$26.51	$73.12	$165.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $73.12 / $253.17	Professional		$26.51	$73.12	$253.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $37.22 / $37.22 / $37.22	Professional		$37.22	$37.22	$37.22
United Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $28.10 / $33.54	Professional		$26.51	$28.10	$33.54