Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.58 / $2.58 / $2.58	Facility		$2.58	$2.58	$2.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.94 / $2.58 / $3.38	Professional		$1.94	$2.58	$3.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.44 / $4.44 / $7.33	Facility		$4.44	$4.44	$7.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.13 / $4.44 / $5.05	Professional		$4.13	$4.44	$5.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.44 / $9.50 / $9.50	Facility		$4.44	$9.50	$9.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11.71 / $13.69 / $18.19	Facility		$11.71	$13.69	$18.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.27 / $6.56 / $8.41	Professional		$2.27	$6.56	$8.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2.50 / $3.61 / $4.44	Facility		$2.50	$3.61	$4.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2.54 / $2.54 / $4.44	Professional		$2.54	$2.54	$4.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $2.52 / $3.66 / $4.66	Facility		$2.52	$3.66	$4.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $2.06 / $2.50 / $5.63	Professional		$2.06	$2.50	$5.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.13 / $58.40 / $85.00	Professional		$2.13	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2.50 / $3.66 / $4.44	Facility		$2.50	$3.66	$4.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2.54 / $2.54 / $4.44	Professional		$2.54	$2.54	$4.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.44 / $6.66 / $11.00	Professional		$4.44	$6.66	$11.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $8.68 / $9.01 / $80.00	Facility		$8.68	$9.01	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2.27 / $19.53 / $22.11	Professional		$2.27	$19.53	$22.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4.44 / $4.44 / $4.44	Professional		$4.44	$4.44	$4.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4.44 / $4.44 / $4.44	Professional		$4.44	$4.44	$4.44
United Facility/Professional Professional Modifier Low / Median / High Price $1.87 / $2.21 / $4.12	Professional		$1.87	$2.21	$4.12