Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.68 / $31.59 / $37.22	Facility		$16.68	$31.59	$37.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $16.68 / $42.73	Professional		$16.20	$16.68	$42.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.25 / $20.25 / $20.25	Facility		$20.25	$20.25	$20.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $16.20 / $20.57	Professional		$16.20	$16.20	$20.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.18 / $22.18 / $25.92	Facility		$22.18	$22.18	$25.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.20 / $38.51 / $55.05	Facility		$16.20	$38.51	$55.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.39 / $24.89 / $28.29	Professional		$16.39	$24.89	$28.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.64 / $16.20 / $16.20	Facility		$10.64	$16.20	$16.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $10.15 / $32.40 / $32.40	Professional		$10.15	$32.40	$32.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.64 / $16.20 / $16.20	Facility		$10.64	$16.20	$16.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $16.20 / $32.40	Professional		$16.20	$16.20	$32.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.07 / $65.00 / $85.00	Professional		$16.07	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.64 / $16.20 / $16.20	Facility		$10.64	$16.20	$16.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $10.15 / $32.40 / $32.40	Professional		$10.15	$32.40	$32.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $17.17 / $55.11	Professional		$16.20	$17.17	$55.11
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 $16.20 / $16.20 / $16.20	Professional		$16.20	$16.20	$16.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $16.20 / $16.20	Professional		$16.20	$16.20	$16.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.19 / $22.74 / $25.55	Professional		$20.19	$22.74	$25.55
United Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $16.20 / $23.65	Professional		$16.20	$16.20	$23.65