Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.07 / $18.07 / $18.07	Facility		$18.07	$18.07	$18.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.13 / $18.07 / $71.14	Professional		$17.13	$18.07	$71.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.66 / $24.66 / $40.69	Facility		$24.66	$24.66	$40.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.93 / $22.93 / $27.12	Professional		$22.93	$22.93	$27.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.19 / $52.77 / $52.77	Facility		$22.19	$52.77	$52.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.68 / $77.92 / $119.54	Facility		$66.68	$77.92	$119.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $35.63 / $46.66	Professional		$20.35	$35.63	$46.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.13 / $24.66 / $25.89	Facility		$17.13	$24.66	$25.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $8.82 / $8.82 / $8.82	Professional		$8.82	$8.82	$8.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.07 / $24.66 / $115.41	Facility		$18.07	$24.66	$115.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $27.88 / $74.87	Professional		$12.30	$27.88	$74.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $90.00	Professional		$65.00	$65.00	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $17.13 / $24.66 / $25.89	Facility		$17.13	$24.66	$25.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $8.82 / $8.82 / $8.82	Professional		$8.82	$8.82	$8.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $37.52 / $74.27	Professional		$24.66	$37.52	$74.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $48.16 / $50.06 / $115.41	Facility		$48.16	$50.06	$115.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $20.35 / $20.35	Professional		$20.35	$20.35	$20.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $24.66 / $24.66	Professional		$24.66	$24.66	$24.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $24.66 / $24.66	Professional		$24.66	$24.66	$24.66
United Facility/Professional Professional Modifier Low / Median / High Price $9.63 / $24.60 / $75.15	Professional		$9.63	$24.60	$75.15