Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.94 / $9.94 / $28.40	Facility		$9.94	$9.94	$28.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.47 / $9.94 / $14.66	Professional		$7.47	$9.94	$14.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.11 / $17.11 / $28.23	Facility		$17.11	$17.11	$28.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.91 / $17.11 / $19.50	Professional		$15.91	$17.11	$19.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.11 / $36.61 / $36.61	Facility		$17.11	$36.61	$36.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.96 / $53.70 / $71.38	Facility		$45.96	$53.70	$71.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.75 / $24.84 / $32.39	Professional		$8.75	$24.84	$32.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $9.61 / $13.92 / $17.11	Facility		$9.61	$13.92	$17.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $9.78 / $9.78 / $17.11	Professional		$9.78	$9.78	$17.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $9.69 / $14.10 / $17.89	Facility		$9.69	$14.10	$17.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $7.96 / $9.68 / $21.69	Professional		$7.96	$9.68	$21.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.02 / $65.00 / $85.00	Professional		$8.02	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $9.61 / $14.10 / $17.11	Facility		$9.61	$14.10	$17.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $9.78 / $9.78 / $17.11	Professional		$9.78	$9.78	$17.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.11 / $25.67 / $43.00	Professional		$17.11	$25.67	$43.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $33.42 / $34.72 / $80.50	Facility		$33.42	$34.72	$80.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.75 / $75.20 / $85.21	Professional		$8.75	$75.20	$85.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.11 / $17.11 / $17.11	Professional		$17.11	$17.11	$17.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.11 / $17.11 / $17.11	Professional		$17.11	$17.11	$17.11
United Facility/Professional Professional Modifier Low / Median / High Price $7.19 / $8.53 / $15.95	Professional		$7.19	$8.53	$15.95