Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.63 / $27.71 / $32.61	Facility		$14.63	$27.71	$32.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $14.66 / $24.41	Professional		$14.23	$14.66	$24.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.79 / $26.33 / $31.73	Facility		$17.79	$26.33	$31.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $14.23 / $18.07	Professional		$14.23	$14.23	$18.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.48 / $19.48 / $22.77	Facility		$19.48	$19.48	$22.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.23 / $18.14 / $40.35	Facility		$14.23	$18.14	$40.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.59 / $21.66 / $24.61	Professional		$14.59	$21.66	$24.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.21 / $14.21 / $31.37	Facility		$14.21	$14.21	$31.37
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $21.32 / $28.46 / $28.46	Professional		$21.32	$28.46	$28.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.21 / $14.21 / $31.37	Facility		$14.21	$14.21	$31.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $15.92 / $28.46	Professional		$14.21	$15.92	$28.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.34 / $14.34 / $85.00	Professional		$14.34	$14.34	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.21 / $14.21 / $31.37	Facility		$14.21	$14.21	$31.37
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $21.32 / $28.46 / $28.46	Professional		$21.32	$28.46	$28.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $17.64 / $49.50	Professional		$14.23	$17.64	$49.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Facility		$85.00	$85.00	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $14.23 / $14.23	Professional		$14.23	$14.23	$14.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $14.21 / $14.21	Professional		$14.21	$14.21	$14.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $19.98 / $19.98	Professional		$19.98	$19.98	$19.98
United Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $15.94 / $19.92	Professional		$14.23	$15.94	$19.92