Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.93 / $13.93 / $13.93	Facility		$13.93	$13.93	$13.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.93 / $15.19 / $19.32	Professional		$13.93	$15.19	$19.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $26.39 / $43.66	Facility		$23.99	$26.39	$43.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.59 / $22.31 / $29.50	Professional		$21.59	$22.31	$29.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.26 / $51.34 / $51.34	Facility		$17.26	$51.34	$51.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.93 / $64.88 / $100.77	Facility		$15.93	$64.88	$100.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.78 / $34.69 / $45.41	Professional		$9.78	$34.69	$45.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.57 / $20.10 / $27.59	Facility		$6.57	$20.10	$27.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $13.74 / $23.99 / $28.79	Professional		$13.74	$23.99	$28.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $11.68 / $25.07 / $112.69	Facility		$11.68	$25.07	$112.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $9.56 / $11.97 / $26.13	Professional		$9.56	$11.97	$26.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.84 / $55.00 / $85.00	Professional		$10.84	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.57 / $20.90 / $27.59	Facility		$6.57	$20.90	$27.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $13.74 / $23.99 / $28.79	Professional		$13.74	$23.99	$28.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.93 / $61.23	Professional		$23.99	$36.93	$61.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15.93 / $46.86 / $112.69	Facility		$15.93	$46.86	$112.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $9.78 / $15.93 / $119.47	Professional		$9.78	$15.93	$119.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $23.99	Professional		$23.99	$23.99	$23.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $23.99	Professional		$23.99	$23.99	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $7.98 / $11.97 / $20.30	Professional		$7.98	$11.97	$20.30