Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.94 / $4.94 / $4.94	Facility		$4.94	$4.94	$4.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.68 / $4.94 / $19.43	Professional		$4.68	$4.94	$19.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6.74 / $6.74 / $11.12	Facility		$6.74	$6.74	$11.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.27 / $6.27 / $7.41	Professional		$6.27	$6.27	$7.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.07 / $14.42 / $14.42	Facility		$6.07	$14.42	$14.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.02 / $21.06 / $32.31	Facility		$18.02	$21.06	$32.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $9.84 / $12.75	Professional		$5.50	$9.84	$12.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4.68 / $6.74 / $7.08	Facility		$4.68	$6.74	$7.08
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2.41 / $2.41 / $2.41	Professional		$2.41	$2.41	$2.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $4.68 / $6.74 / $233.62	Facility		$4.68	$6.74	$233.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $3.36 / $7.62 / $20.45	Professional		$3.36	$7.62	$20.45
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 $2.52 / $5.55 / $7.08	Facility		$2.52	$5.55	$7.08
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2.41 / $2.41 / $2.41	Professional		$2.41	$2.41	$2.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.74 / $10.14 / $20.07	Professional		$6.74	$10.14	$20.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13.16 / $13.16 / $233.62	Facility		$13.16	$13.16	$233.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $5.50 / $5.50	Professional		$5.50	$5.50	$5.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6.74 / $6.74 / $6.74	Professional		$6.74	$6.74	$6.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6.74 / $6.74 / $6.74	Professional		$6.74	$6.74	$6.74
United Facility/Professional Facility Modifier Low / Median / High Price $6.74 / $6.74 / $6.74	Facility		$6.74	$6.74	$6.74
United Facility/Professional Professional Modifier Low / Median / High Price $2.63 / $6.74 / $20.45	Professional		$2.63	$6.74	$20.45