Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.02 / $15.02 / $15.02	Facility		$15.02	$15.02	$15.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.93 / $15.02 / $20.83	Professional		$13.93	$15.02	$20.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.88 / $28.47 / $47.10	Facility		$25.88	$28.47	$47.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.38 / $24.07 / $31.83	Professional		$22.38	$24.07	$31.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $55.38 / $55.38	Facility		$18.62	$55.38	$55.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.54 / $69.39 / $107.77	Facility		$15.54	$69.39	$107.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.56 / $37.50 / $48.98	Professional		$10.56	$37.50	$48.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $7.08 / $21.67 / $29.76	Facility		$7.08	$21.67	$29.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.82 / $25.88 / $31.06	Professional		$14.82	$25.88	$31.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $27.04 / $117.09	Facility		$12.59	$27.04	$117.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $13.22 / $30.00	Professional		$10.45	$13.22	$30.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.67 / $55.00 / $85.00	Professional		$11.67	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $7.08 / $22.53 / $29.76	Facility		$7.08	$22.53	$29.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.82 / $25.88 / $31.06	Professional		$14.82	$25.88	$31.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.88 / $39.83 / $66.23	Professional		$25.88	$39.83	$66.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15.54 / $50.54 / $117.09	Facility		$15.54	$50.54	$117.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.56 / $15.54 / $113.72	Professional		$10.56	$15.54	$113.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.88 / $25.88 / $25.88	Professional		$25.88	$25.88	$25.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.88 / $25.88 / $25.88	Professional		$25.88	$25.88	$25.88
United Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $11.00 / $16.48	Facility		$8.71	$11.00	$16.48
United Facility/Professional Professional Modifier Low / Median / High Price $9.15 / $12.91 / $24.11	Professional		$9.15	$12.91	$24.11