Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.29 / $29.07 / $34.25	Facility		$15.29	$29.07	$34.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.85 / $15.29 / $37.26	Professional		$14.85	$15.29	$37.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.55 / $27.45 / $33.09	Facility		$18.55	$27.45	$33.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.85 / $14.85 / $18.85	Professional		$14.85	$14.85	$18.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.34 / $20.34 / $23.76	Facility		$20.34	$20.34	$23.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.84 / $18.89 / $39.83	Facility		$14.84	$18.89	$39.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.84 / $22.11 / $25.13	Professional		$14.84	$22.11	$25.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.85 / $14.91 / $32.79	Facility		$14.85	$14.91	$32.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $22.37 / $29.70 / $29.70	Professional		$22.37	$29.70	$29.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.91 / $14.91 / $32.79	Facility		$14.91	$14.91	$32.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.91 / $16.70 / $29.70	Professional		$14.91	$16.70	$29.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.28 / $65.00 / $85.00	Professional		$14.28	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.85 / $14.91 / $32.79	Facility		$14.85	$14.91	$32.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $22.37 / $29.70 / $29.70	Professional		$22.37	$29.70	$29.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.84 / $15.74 / $48.40	Professional		$14.84	$15.74	$48.40
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 $14.84 / $14.84 / $14.84	Professional		$14.84	$14.84	$14.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $14.91 / $14.91 / $14.91	Professional		$14.91	$14.91	$14.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.85 / $20.85 / $20.85	Professional		$20.85	$20.85	$20.85
United Facility/Professional Professional Modifier Low / Median / High Price $14.85 / $16.63 / $22.28	Professional		$14.85	$16.63	$22.28