Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.35 / $34.29 / $40.40	Facility		$17.35	$34.29	$40.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.84 / $17.35 / $36.72	Professional		$16.84	$17.35	$36.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.05 / $31.15 / $37.54	Facility		$21.05	$31.15	$37.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.84 / $16.84 / $21.38	Professional		$16.84	$16.84	$21.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.05 / $23.05 / $26.94	Facility		$23.05	$23.05	$26.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.84 / $21.48 / $46.80	Facility		$16.84	$21.48	$46.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $24.83 / $28.21	Professional		$16.98	$24.83	$28.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $17.59 / $37.07	Facility		$12.59	$17.59	$37.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.39 / $33.68 / $33.68	Professional		$26.39	$33.68	$33.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $17.59 / $38.49	Facility		$12.59	$17.59	$38.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.59 / $19.70 / $33.68	Professional		$17.59	$19.70	$33.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.68 / $55.00 / $85.00	Professional		$16.68	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $17.59 / $37.07	Facility		$12.59	$17.59	$37.07
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.39 / $33.68 / $33.68	Professional		$26.39	$33.68	$33.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.84 / $17.85 / $55.11	Professional		$16.84	$17.85	$55.11
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 $16.84 / $16.84 / $16.84	Professional		$16.84	$16.84	$16.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.59 / $17.59 / $17.59	Professional		$17.59	$17.59	$17.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.01 / $23.64 / $24.70	Professional		$17.01	$23.64	$24.70
United Facility/Professional Facility Modifier Low / Median / High Price $16.82 / $16.82 / $16.82	Facility		$16.82	$16.82	$16.82
United Facility/Professional Professional Modifier Low / Median / High Price $16.84 / $18.86 / $23.58	Professional		$16.84	$18.86	$23.58