Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.76 / $2.76 / $2.76	Facility		$2.76	$2.76	$2.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.08 / $2.76 / $3.62	Professional		$2.08	$2.76	$3.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.76 / $4.76 / $7.85	Facility		$4.76	$4.76	$7.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.43 / $4.76 / $5.42	Professional		$4.43	$4.76	$5.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.76 / $10.19 / $10.19	Facility		$4.76	$10.19	$10.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.62 / $14.74 / $19.59	Facility		$12.62	$14.74	$19.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.94 / $7.03 / $9.01	Professional		$1.94	$7.03	$9.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2.67 / $3.49 / $4.76	Facility		$2.67	$3.49	$4.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2.71 / $2.71 / $4.76	Professional		$2.71	$2.71	$4.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $2.70 / $3.86 / $4.97	Facility		$2.70	$3.86	$4.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $2.21 / $2.70 / $6.03	Professional		$2.21	$2.70	$6.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2.67 / $3.86 / $4.76	Facility		$2.67	$3.86	$4.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2.71 / $2.71 / $4.76	Professional		$2.71	$2.71	$4.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.76 / $7.14 / $12.00	Professional		$4.76	$7.14	$12.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9.30 / $9.66 / $80.00	Facility		$9.30	$9.66	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1.94 / $20.93 / $23.70	Professional		$1.94	$20.93	$23.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4.76 / $4.76 / $4.76	Professional		$4.76	$4.76	$4.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4.76 / $4.76 / $4.76	Professional		$4.76	$4.76	$4.76
United Facility/Professional Professional Modifier Low / Median / High Price $1.58 / $2.38 / $4.43	Professional		$1.58	$2.38	$4.43