Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.55 / $27.53 / $32.45	Facility		$14.55	$27.53	$32.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.34 / $14.77 / $28.45	Professional		$14.34	$14.77	$28.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.93 / $26.53 / $31.98	Facility		$17.93	$26.53	$31.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.34 / $14.34 / $18.21	Professional		$14.34	$14.34	$18.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.63 / $19.63 / $22.94	Facility		$19.63	$19.63	$22.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.34 / $17.68 / $36.76	Facility		$14.34	$17.68	$36.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.91 / $20.20 / $22.95	Professional		$13.91	$20.20	$22.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $9.27 / $14.12 / $31.37	Facility		$9.27	$14.12	$31.37
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $21.18 / $28.68 / $28.68	Professional		$21.18	$28.68	$28.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $9.27 / $14.12 / $31.37	Facility		$9.27	$14.12	$31.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.12 / $15.81 / $28.68	Professional		$14.12	$15.81	$28.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.64 / $65.00 / $85.00	Professional		$13.64	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $9.27 / $14.12 / $31.37	Facility		$9.27	$14.12	$31.37
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $21.18 / $28.68 / $28.68	Professional		$21.18	$28.68	$28.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.34 / $15.11 / $45.39	Professional		$14.34	$15.11	$45.39
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 $14.34 / $14.34 / $14.34	Professional		$14.34	$14.34	$14.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $14.12 / $14.12 / $14.12	Professional		$14.12	$14.12	$14.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $12.64 / $20.13 / $20.13	Professional		$12.64	$20.13	$20.13
United Facility/Professional Professional Modifier Low / Median / High Price $14.34 / $16.05 / $21.51	Professional		$14.34	$16.05	$21.51