Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.64 / $12.64 / $12.64	Facility		$12.64	$12.64	$12.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.99 / $12.64 / $49.79	Professional		$11.99	$12.64	$49.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.25 / $17.25 / $28.46	Facility		$17.25	$17.25	$28.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.04 / $16.04 / $18.97	Professional		$16.04	$16.04	$18.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.53 / $36.92 / $36.92	Facility		$15.53	$36.92	$36.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.96 / $53.70 / $82.38	Facility		$45.96	$53.70	$82.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $24.84 / $32.65	Professional		$10.19	$24.84	$32.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $11.99 / $17.25 / $18.11	Facility		$11.99	$17.25	$18.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $6.14 / $6.14 / $6.14	Professional		$6.14	$6.14	$6.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $11.99 / $17.25 / $158.10	Facility		$11.99	$17.25	$158.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.61 / $19.52 / $52.41	Professional		$8.61	$19.52	$52.41
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 $6.48 / $14.22 / $18.11	Facility		$6.48	$14.22	$18.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $6.14 / $6.14 / $6.14	Professional		$6.14	$6.14	$6.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $25.88 / $51.19	Professional		$17.25	$25.88	$51.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $33.70 / $33.70 / $158.10	Facility		$33.70	$33.70	$158.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $10.19 / $10.19	Professional		$10.19	$10.19	$10.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $17.25 / $17.25	Professional		$17.25	$17.25	$17.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $17.25 / $17.25	Professional		$17.25	$17.25	$17.25
United Facility/Professional Professional Modifier Low / Median / High Price $6.74 / $16.75 / $52.41	Professional		$6.74	$16.75	$52.41