Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.69 / $26.01 / $30.64	Facility		$13.69	$26.01	$30.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.29 / $13.69 / $31.26	Professional		$13.29	$13.69	$31.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.61 / $24.59 / $29.64	Facility		$16.61	$24.59	$29.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.29 / $13.29 / $16.87	Professional		$13.29	$13.29	$16.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.19 / $18.19 / $21.26	Facility		$18.19	$18.19	$21.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.29 / $31.54 / $45.09	Facility		$13.29	$31.54	$45.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.29 / $20.32 / $23.09	Professional		$13.29	$20.32	$23.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.84 / $13.29 / $13.34	Facility		$10.84	$13.29	$13.34
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $6.14 / $26.58 / $26.58	Professional		$6.14	$26.58	$26.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.84 / $13.34 / $13.34	Facility		$10.84	$13.34	$13.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.34 / $13.34 / $26.58	Professional		$13.34	$13.34	$26.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $65.00 / $85.00	Professional		$13.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.84 / $13.29 / $13.34	Facility		$10.84	$13.29	$13.34
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $6.14 / $26.58 / $26.58	Professional		$6.14	$26.58	$26.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.29 / $20.14 / $40.00	Professional		$13.29	$20.14	$40.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.29 / $13.29 / $13.29	Professional		$13.29	$13.29	$13.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $18.66 / $19.32	Professional		$15.00	$18.66	$19.32
United Facility/Professional Professional Modifier Low / Median / High Price $13.29 / $13.29 / $18.20	Professional		$13.29	$13.29	$18.20