Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.31 / $41.82 / $74.98	Facility		$12.31	$41.82	$74.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.62 / $7.71 / $9.13	Professional		$7.62	$7.71	$9.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.53 / $9.53 / $9.53	Facility		$9.53	$9.53	$9.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.63 / $7.63 / $10.30	Professional		$7.63	$7.63	$10.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5.36 / $8.03 / $11.45	Facility		$5.36	$8.03	$11.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5.36 / $7.63 / $17.70	Professional		$5.36	$7.63	$17.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.96 / $5.41 / $7.66	Facility		$2.96	$5.41	$7.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $7.63 / $10.92	Professional		$5.01	$7.63	$10.92
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2.98 / $7.63 / $9.13	Facility		$2.98	$7.63	$9.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $15.26 / $15.26	Professional		$0.80	$15.26	$15.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $4.94 / $5.52 / $41.37	Facility		$4.94	$5.52	$41.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $5.36 / $5.36 / $48.89	Professional		$5.36	$5.36	$48.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.91 / $65.00 / $85.00	Professional		$20.91	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2.98 / $7.63 / $8.44	Facility		$2.98	$7.63	$8.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $15.26 / $15.26	Professional		$0.80	$15.26	$15.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.40 / $7.63 / $10.22	Professional		$5.40	$7.63	$10.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7.63 / $7.63 / $100.00	Facility		$7.63	$7.63	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.63 / $12.32 / $48.89	Professional		$7.63	$12.32	$48.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5.37 / $10.71 / $10.71	Professional		$5.37	$10.71	$10.71
United Facility/Professional Professional Modifier Low / Median / High Price $7.63 / $7.63 / $10.45	Professional		$7.63	$7.63	$10.45