Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11.88 / $22.52 / $26.54	Facility		$11.88	$22.52	$26.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $11.88 / $29.42	Professional		$11.53	$11.88	$29.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.43 / $21.35 / $25.73	Facility		$14.43	$21.35	$25.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.54 / $11.54 / $14.65	Professional		$11.54	$11.54	$14.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.80 / $15.80 / $18.46	Facility		$15.80	$15.80	$18.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11.54 / $27.97 / $39.97	Facility		$11.54	$27.97	$39.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.74 / $17.98 / $20.44	Professional		$11.74	$17.98	$20.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $9.94 / $11.54 / $11.55	Facility		$9.94	$11.54	$11.55
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $6.42 / $23.08 / $23.08	Professional		$6.42	$23.08	$23.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $9.94 / $11.55 / $11.55	Facility		$9.94	$11.55	$11.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.55 / $11.55 / $23.08	Professional		$11.55	$11.55	$23.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.52 / $65.00 / $85.00	Professional		$11.52	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $9.94 / $11.54 / $11.55	Facility		$9.94	$11.54	$11.55
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $6.42 / $23.08 / $23.08	Professional		$6.42	$23.08	$23.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $17.85 / $36.00	Professional		$11.53	$17.85	$36.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $11.54 / $11.54 / $100.00	Facility		$11.54	$11.54	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.54 / $11.54 / $11.54	Professional		$11.54	$11.54	$11.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $13.73 / $16.20 / $17.37	Professional		$13.73	$16.20	$17.37
United Facility/Professional Facility Modifier Low / Median / High Price $11.53 / $11.53 / $11.53	Facility		$11.53	$11.53	$11.53
United Facility/Professional Professional Modifier Low / Median / High Price $11.54 / $11.54 / $15.80	Professional		$11.54	$11.54	$15.80