Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.12 / $4.12 / $4.12	Facility		$4.12	$4.12	$4.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.12 / $4.12 / $4.38	Professional		$4.12	$4.12	$4.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.79 / $26.79 / $44.20	Facility		$26.79	$26.79	$44.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.91 / $26.79 / $30.54	Professional		$24.91	$26.79	$30.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.79 / $57.33 / $57.33	Facility		$26.79	$57.33	$57.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.09 / $84.24 / $111.97	Facility		$72.09	$84.24	$111.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $38.90 / $50.70	Professional		$13.56	$38.90	$50.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4.12 / $4.38 / $26.79	Facility		$4.12	$4.38	$26.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.79 / $26.79 / $26.79	Professional		$26.79	$26.79	$26.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $4.12 / $4.38 / $26.79	Facility		$4.12	$4.38	$26.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.08 / $15.25 / $38.01	Professional		$14.08	$15.25	$38.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $4.12 / $4.38 / $26.79	Facility		$4.12	$4.38	$26.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.79 / $26.79 / $26.79	Professional		$26.79	$26.79	$26.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.79 / $40.19 / $68.25	Professional		$26.79	$40.19	$68.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $52.32 / $54.38 / $115.97	Facility		$52.32	$54.38	$115.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $117.72 / $133.41	Professional		$13.56	$117.72	$133.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $26.79 / $26.79 / $26.79	Professional		$26.79	$26.79	$26.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $26.79 / $26.79 / $26.79	Professional		$26.79	$26.79	$26.79
United Facility/Professional Professional Modifier Low / Median / High Price $11.15 / $14.08 / $24.89	Professional		$11.15	$14.08	$24.89