Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.77 / $15.77 / $15.77	Facility		$15.77	$15.77	$15.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.73 / $15.77 / $20.81	Professional		$14.73	$15.77	$20.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.17 / $29.89 / $49.45	Facility		$27.17	$29.89	$49.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.45 / $25.27 / $33.40	Professional		$24.45	$25.27	$33.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.55 / $58.14 / $58.14	Facility		$19.55	$58.14	$58.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.44 / $73.89 / $114.76	Facility		$16.44	$73.89	$114.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.97 / $40.47 / $51.41	Professional		$13.97	$40.47	$51.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $7.49 / $22.92 / $31.25	Facility		$7.49	$22.92	$31.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $15.67 / $26.54 / $32.60	Professional		$15.67	$26.54	$32.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.32 / $28.39 / $121.07	Facility		$13.32	$28.39	$121.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.04 / $13.98 / $31.51	Professional		$11.04	$13.98	$31.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.25 / $55.00 / $85.00	Professional		$10.25	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $7.49 / $23.66 / $31.25	Facility		$7.49	$23.66	$31.25
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $15.67 / $26.54 / $32.60	Professional		$15.67	$26.54	$32.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.17 / $41.81 / $69.26	Professional		$27.17	$41.81	$69.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16.44 / $53.06 / $121.07	Facility		$16.44	$53.06	$121.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.97 / $16.44 / $136.25	Professional		$13.97	$16.44	$136.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.17 / $27.17 / $27.17	Professional		$27.17	$27.17	$27.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.17 / $27.17 / $27.17	Professional		$27.17	$27.17	$27.17
United Facility/Professional Professional Modifier Low / Median / High Price $9.08 / $13.55 / $25.98	Professional		$9.08	$13.55	$25.98