Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.43 / $19.75 / $23.26	Facility		$10.43	$19.75	$23.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.14 / $10.44 / $21.41	Professional		$10.14	$10.44	$21.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.68 / $18.76 / $22.61	Facility		$12.68	$18.76	$22.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.14 / $10.14 / $12.87	Professional		$10.14	$10.14	$12.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.88 / $13.88 / $16.22	Facility		$13.88	$13.88	$16.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10.14 / $23.41 / $33.46	Facility		$10.14	$23.41	$33.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.14 / $14.10 / $16.03	Professional		$10.14	$14.10	$16.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.96 / $10.13 / $22.10	Facility		$6.96	$10.13	$22.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4.54 / $20.28 / $20.28	Professional		$4.54	$20.28	$20.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $1.93 / $10.13 / $22.10	Facility		$1.93	$10.13	$22.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.13 / $10.13 / $20.28	Professional		$10.13	$10.13	$20.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.69 / $65.00 / $85.00	Professional		$9.69	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.96 / $10.13 / $22.10	Facility		$6.96	$10.13	$22.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4.54 / $20.28 / $20.28	Professional		$4.54	$20.28	$20.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.14 / $13.14 / $30.00	Professional		$10.14	$13.14	$30.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10.14 / $10.14 / $100.00	Facility		$10.14	$10.14	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.14 / $10.14 / $10.14	Professional		$10.14	$10.14	$10.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10.13 / $10.13 / $10.13	Professional		$10.13	$10.13	$10.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $9.66 / $14.24 / $14.45	Professional		$9.66	$14.24	$14.45
United Facility/Professional Professional Modifier Low / Median / High Price $10.14 / $10.14 / $14.20	Professional		$10.14	$10.14	$14.20