Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.90 / $14.90 / $14.90	Facility		$14.90	$14.90	$14.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.27 / $14.90 / $20.14	Professional		$14.27	$14.90	$20.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.65 / $28.22 / $46.68	Facility		$25.65	$28.22	$46.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.18 / $23.85 / $31.54	Professional		$22.18	$23.85	$31.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.47 / $54.89 / $54.89	Facility		$18.47	$54.89	$54.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.42 / $69.39 / $107.77	Facility		$15.42	$69.39	$107.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.11 / $37.61 / $48.55	Professional		$13.11	$37.61	$48.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $7.02 / $21.15 / $29.50	Facility		$7.02	$21.15	$29.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $25.65 / $30.78	Professional		$14.70	$25.65	$30.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.49 / $25.65 / $116.25	Facility		$12.49	$25.65	$116.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.06 / $12.80 / $27.94	Professional		$10.06	$12.80	$27.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.51 / $55.00 / $85.00	Professional		$14.51	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $7.02 / $22.35 / $29.50	Facility		$7.02	$22.35	$29.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $25.65 / $30.78	Professional		$14.70	$25.65	$30.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $39.47 / $65.23	Professional		$25.65	$39.47	$65.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15.42 / $50.10 / $116.25	Facility		$15.42	$50.10	$116.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.11 / $15.42 / $165.74	Professional		$13.11	$15.42	$165.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $25.65 / $25.65	Professional		$25.65	$25.65	$25.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $25.65 / $25.65	Professional		$25.65	$25.65	$25.65
United Facility/Professional Professional Modifier Low / Median / High Price $8.53 / $12.80 / $21.70	Professional		$8.53	$12.80	$21.70