Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.50 / $23.67 / $27.88	Facility		$12.50	$23.67	$27.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.14 / $12.51 / $26.67	Professional		$12.14	$12.51	$26.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.18 / $22.46 / $27.07	Facility		$15.18	$22.46	$27.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.14 / $12.14 / $15.41	Professional		$12.14	$12.14	$15.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.63 / $16.63 / $19.42	Facility		$16.63	$16.63	$19.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.14 / $29.57 / $42.28	Facility		$12.14	$29.57	$42.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.38 / $18.12 / $20.59	Professional		$12.38	$18.12	$20.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.14 / $12.14 / $27.09	Facility		$12.14	$12.14	$27.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $18.21 / $24.28 / $24.28	Professional		$18.21	$24.28	$24.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.14 / $12.14 / $27.09	Facility		$12.14	$12.14	$27.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.14 / $12.14 / $24.28	Professional		$12.14	$12.14	$24.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.15 / $65.00 / $85.00	Professional		$12.15	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.14 / $12.14 / $27.09	Facility		$12.14	$12.14	$27.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $18.21 / $24.28 / $24.28	Professional		$18.21	$24.28	$24.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.14 / $16.32 / $41.80	Professional		$12.14	$16.32	$41.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $12.14 / $12.14 / $85.00	Facility		$12.14	$12.14	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.14 / $12.14 / $12.14	Professional		$12.14	$12.14	$12.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $14.67 / $17.04 / $17.04	Professional		$14.67	$17.04	$17.04
United Facility/Professional Professional Modifier Low / Median / High Price $12.14 / $12.14 / $15.78	Professional		$12.14	$12.14	$15.78