Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.65 / $13.65 / $39.01	Facility		$13.65	$13.65	$39.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.26 / $13.65 / $20.13	Professional		$10.26	$13.65	$20.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.50 / $23.50 / $38.78	Facility		$23.50	$23.50	$38.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.86 / $23.50 / $26.79	Professional		$21.86	$23.50	$26.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.50 / $50.29 / $50.29	Facility		$23.50	$50.29	$50.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.08 / $73.70 / $97.97	Facility		$63.08	$73.70	$97.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $34.22 / $44.48	Professional		$12.00	$34.22	$44.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.20 / $19.11 / $23.50	Facility		$13.20	$19.11	$23.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $13.46 / $23.50	Professional		$13.46	$13.46	$23.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.31 / $19.37 / $24.57	Facility		$13.31	$19.37	$24.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.92 / $13.29 / $29.78	Professional		$10.92	$13.29	$29.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.75 / $65.00 / $85.00	Professional		$10.75	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.20 / $19.37 / $23.50	Facility		$13.20	$19.37	$23.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $13.46 / $23.50	Professional		$13.46	$13.46	$23.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $35.25 / $60.00	Professional		$23.50	$35.25	$60.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.90 / $47.71 / $110.59	Facility		$45.90	$47.71	$110.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $103.28 / $117.03	Professional		$12.00	$103.28	$117.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $23.50 / $23.50	Professional		$23.50	$23.50	$23.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $23.50 / $23.50	Professional		$23.50	$23.50	$23.50
United Facility/Professional Professional Modifier Low / Median / High Price $9.88 / $11.72 / $19.54	Professional		$9.88	$11.72	$19.54