Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.19 / $22.19 / $22.19	Facility		$22.19	$22.19	$22.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.95 / $19.97 / $24.53	Professional		$13.95	$19.97	$24.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.50 / $59.15 / $59.15	Facility		$32.50	$59.15	$59.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $30.24 / $43.87	Professional		$30.23	$30.24	$43.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.65 / $19.72 / $69.59	Facility		$2.65	$19.72	$69.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.85 / $21.85 / $31.06	Facility		$21.85	$21.85	$31.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.85 / $37.88 / $47.34	Professional		$21.85	$37.88	$47.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $11.63 / $29.28 / $42.09	Facility		$11.63	$29.28	$42.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.32 / $24.32 / $43.92	Professional		$24.32	$24.32	$43.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $11.63 / $39.94 / $155.56	Facility		$11.63	$39.94	$155.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.27 / $20.25 / $40.77	Professional		$15.27	$20.25	$40.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $50.00 / $65.00	Professional		$15.66	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $11.63 / $29.28 / $42.09	Facility		$11.63	$29.28	$42.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.32 / $24.32 / $43.92	Professional		$24.32	$24.32	$43.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.29 / $7.10 / $9.22	Professional		$4.29	$7.10	$9.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $21.85 / $63.14 / $155.56	Facility		$21.85	$63.14	$155.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.85 / $21.85 / $28.68	Professional		$21.85	$21.85	$28.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $34.56 / $34.56 / $34.56	Professional		$34.56	$34.56	$34.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $34.56 / $34.56 / $34.56	Professional		$34.56	$34.56	$34.56
United Facility/Professional Professional Modifier Low / Median / High Price $12.21 / $19.75 / $38.81	Professional		$12.21	$19.75	$38.81