Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.95 / $13.95 / $13.95	Facility		$13.95	$13.95	$13.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.81 / $12.90 / $16.50	Professional		$8.81	$12.90	$16.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.90 / $45.32 / $45.32	Facility		$24.90	$45.32	$45.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.47 / $23.16 / $29.20	Professional		$19.47	$23.16	$29.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1.79 / $11.65 / $44.81	Facility		$1.79	$11.65	$44.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.93 / $13.93 / $55.87	Facility		$13.93	$13.93	$55.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.93 / $24.38 / $30.47	Professional		$13.93	$24.38	$30.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.75 / $13.95 / $25.11	Facility		$6.75	$13.95	$25.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.10 / $14.10 / $25.13	Professional		$14.10	$14.10	$25.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $6.75 / $25.13 / $112.37	Facility		$6.75	$25.13	$112.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.85 / $12.19 / $25.23	Professional		$8.85	$12.19	$25.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.75 / $13.95 / $25.11	Facility		$6.75	$13.95	$25.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.10 / $14.10 / $25.13	Professional		$14.10	$14.10	$25.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3.21 / $4.73 / $6.15	Professional		$3.21	$4.73	$6.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13.93 / $40.90 / $112.37	Facility		$13.93	$40.90	$112.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.93 / $13.93 / $17.41	Professional		$13.93	$13.93	$17.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.94 / $20.94 / $20.94	Professional		$20.94	$20.94	$20.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.94 / $20.94 / $20.94	Professional		$20.94	$20.94	$20.94
United Facility/Professional Professional Modifier Low / Median / High Price $8.18 / $11.59 / $24.28	Professional		$8.18	$11.59	$24.28