Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.01 / $6.00 / $6.87	Facility		$3.01	$6.00	$6.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.93 / $2.96 / $3.51	Professional		$2.93	$2.96	$3.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3.66 / $3.66 / $3.66	Facility		$3.66	$3.66	$3.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.93 / $2.93 / $3.66	Professional		$2.93	$2.93	$3.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.01 / $4.01 / $4.69	Facility		$4.01	$4.01	$4.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.93 / $4.59 / $12.71	Facility		$2.93	$4.59	$12.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.93 / $3.31 / $5.19	Professional		$2.93	$3.31	$5.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2.93 / $3.00 / $6.04	Facility		$2.93	$3.00	$6.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $5.86 / $5.86 / $5.86	Professional		$5.86	$5.86	$5.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $3.00 / $3.02 / $9.19	Facility		$3.00	$3.02	$9.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $3.00 / $1,664.49	Professional		$3.00	$3.00	$1,664.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2.93 / $3.00 / $6.04	Facility		$2.93	$3.00	$6.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $5.86 / $5.86 / $5.86	Professional		$5.86	$5.86	$5.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2.93 / $4.72 / $9.00	Professional		$2.93	$4.72	$9.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2.93 / $65.00 / $100.00	Facility		$2.93	$65.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2.93 / $7.90 / $1,664.49	Professional		$2.93	$7.90	$1,664.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4.11 / $4.30 / $7.12	Professional		$4.11	$4.30	$7.12
United Facility/Professional Professional Modifier Low / Median / High Price $2.93 / $2.93 / $3.81	Professional		$2.93	$2.93	$3.81