Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.63 / $14.63 / $14.63	Facility		$14.63	$14.63	$14.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.57 / $14.63 / $20.30	Professional		$13.57	$14.63	$20.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.20 / $27.72 / $45.86	Facility		$25.20	$27.72	$45.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.79 / $23.44 / $30.99	Professional		$21.79	$23.44	$30.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.14 / $53.93 / $53.93	Facility		$18.14	$53.93	$53.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.15 / $67.58 / $104.97	Facility		$15.15	$67.58	$104.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $36.56 / $47.70	Professional		$12.88	$36.56	$47.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.90 / $21.11 / $28.98	Facility		$6.90	$21.11	$28.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.43 / $25.20 / $30.24	Professional		$14.43	$25.20	$30.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.26 / $26.33 / $113.07	Facility		$12.26	$26.33	$113.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.17 / $12.88 / $29.22	Professional		$10.17	$12.88	$29.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.85 / $55.00 / $85.00	Professional		$10.85	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.90 / $21.95 / $28.98	Facility		$6.90	$21.95	$28.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.43 / $25.20 / $30.24	Professional		$14.43	$25.20	$30.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $38.77 / $64.23	Professional		$25.20	$38.77	$64.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15.15 / $49.22 / $113.07	Facility		$15.15	$49.22	$113.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.15 / $143.78	Professional		$12.88	$15.15	$143.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $25.20 / $25.20	Professional		$25.20	$25.20	$25.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $25.20 / $25.20	Professional		$25.20	$25.20	$25.20
United Facility/Professional Professional Modifier Low / Median / High Price $8.38 / $12.58 / $25.20	Professional		$8.38	$12.58	$25.20