Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.56 / $15.56 / $44.47	Facility		$15.56	$15.56	$44.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.71 / $15.56 / $22.95	Professional		$11.71	$15.56	$22.95
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 $10.93 / $31.44 / $50.70	Professional		$10.93	$31.44	$50.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.05 / $21.78 / $26.79	Facility		$15.05	$21.78	$26.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $15.35 / $15.35 / $26.79	Professional		$15.35	$15.35	$26.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.18 / $22.08 / $28.01	Facility		$15.18	$22.08	$28.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.46 / $15.15 / $33.95	Professional		$12.46	$15.15	$33.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $65.00 / $85.00	Professional		$28.52	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $15.05 / $22.08 / $26.79	Facility		$15.05	$22.08	$26.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $15.35 / $15.35 / $26.79	Professional		$15.35	$15.35	$26.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.79 / $40.19 / $68.00	Professional		$26.79	$40.19	$68.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $52.32 / $54.38 / $125.85	Facility		$52.32	$54.38	$125.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.93 / $12.04 / $133.41	Professional		$10.93	$12.04	$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 $10.86 / $13.37 / $24.81	Professional		$10.86	$13.37	$24.81