Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.68 / $2.68 / $15.96	Facility		$2.68	$2.68	$15.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.68 / $3.95	Professional		$2.00	$2.68	$3.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.61 / $4.61 / $7.61	Facility		$4.61	$4.61	$7.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.29 / $4.61 / $5.25	Professional		$4.29	$4.61	$5.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.61 / $9.86 / $9.86	Facility		$4.61	$9.86	$9.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.62 / $14.74 / $19.59	Facility		$12.62	$14.74	$19.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.88 / $6.56 / $8.73	Professional		$1.88	$6.56	$8.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2.59 / $3.75 / $4.61	Facility		$2.59	$3.75	$4.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2.63 / $2.63 / $4.61	Professional		$2.63	$2.63	$4.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $2.61 / $3.80 / $4.84	Facility		$2.61	$3.80	$4.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $2.14 / $2.47 / $5.84	Professional		$2.14	$2.47	$5.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.88 / $65.00 / $85.00	Professional		$4.88	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2.59 / $3.80 / $4.61	Facility		$2.59	$3.80	$4.61
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2.63 / $2.63 / $4.61	Professional		$2.63	$2.63	$4.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.61 / $6.92 / $12.00	Professional		$4.61	$6.92	$12.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9.00 / $9.36 / $80.00	Facility		$9.00	$9.36	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1.88 / $20.25 / $22.96	Professional		$1.88	$20.25	$22.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4.61 / $4.61 / $4.61	Professional		$4.61	$4.61	$4.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4.61 / $4.61 / $4.61	Professional		$4.61	$4.61	$4.61
United Facility/Professional Professional Modifier Low / Median / High Price $1.53 / $2.29 / $3.83	Professional		$1.53	$2.29	$3.83