Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $10.00 / $28.59	Facility		$10.00	$10.00	$28.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.52 / $10.00 / $14.75	Professional		$7.52	$10.00	$14.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.22 / $17.22 / $28.41	Facility		$17.22	$17.22	$28.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.01 / $17.22 / $19.63	Professional		$16.01	$17.22	$19.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.22 / $36.85 / $36.85	Facility		$17.22	$36.85	$36.85
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 $8.78 / $24.84 / $32.60	Professional		$8.78	$24.84	$32.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $9.67 / $14.00 / $17.22	Facility		$9.67	$14.00	$17.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $9.85 / $9.85 / $17.22	Professional		$9.85	$9.85	$17.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $9.76 / $14.19 / $18.00	Facility		$9.76	$14.19	$18.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $9.74 / $21.82	Professional		$8.00	$9.74	$21.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.06 / $65.00 / $85.00	Professional		$9.06	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $9.67 / $14.19 / $17.22	Facility		$9.67	$14.19	$17.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $9.85 / $9.85 / $17.22	Professional		$9.85	$9.85	$17.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.22 / $25.83 / $44.00	Professional		$17.22	$25.83	$44.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $33.64 / $34.96 / $81.01	Facility		$33.64	$34.96	$81.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.78 / $75.69 / $85.76	Professional		$8.78	$75.69	$85.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.22 / $17.22 / $17.22	Professional		$17.22	$17.22	$17.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.22 / $17.22 / $17.22	Professional		$17.22	$17.22	$17.22
United Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $8.59 / $14.32	Professional		$7.24	$8.59	$14.32