Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $8.51 / $8.51	Facility		$8.51	$8.51	$8.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.07 / $8.51 / $33.52	Professional		$8.07	$8.51	$33.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.61 / $11.61 / $19.16	Facility		$11.61	$11.61	$19.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $10.80 / $12.77	Professional		$10.80	$10.80	$12.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.45 / $10.45 / $24.85	Facility		$10.45	$10.45	$24.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.54 / $36.86 / $56.54	Facility		$31.54	$36.86	$56.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5.09 / $16.88 / $21.98	Professional		$5.09	$16.88	$21.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8.07 / $11.61 / $12.19	Facility		$8.07	$11.61	$12.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4.26 / $4.26 / $4.26	Professional		$4.26	$4.26	$4.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $11.61 / $85.00	Facility		$8.51	$11.61	$85.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $5.80 / $13.14 / $35.28	Professional		$5.80	$13.14	$35.28
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 $8.07 / $11.61 / $12.19	Facility		$8.07	$11.61	$12.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4.26 / $4.26 / $4.26	Professional		$4.26	$4.26	$4.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.61 / $17.75 / $35.13	Professional		$11.61	$17.75	$35.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $22.68 / $23.57 / $85.00	Facility		$22.68	$23.57	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.09 / $5.09 / $5.09	Professional		$5.09	$5.09	$5.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11.61 / $11.61 / $11.61	Professional		$11.61	$11.61	$11.61
Security Health Facility/Professional Facility Modifier Low / Median / High Price $10.02 / $10.02 / $10.02	Facility		$10.02	$10.02	$10.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11.61 / $11.61 / $11.61	Professional		$11.61	$11.61	$11.61
United Facility/Professional Professional Modifier Low / Median / High Price $4.54 / $12.03 / $42.38	Professional		$4.54	$12.03	$42.38