Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6.23 / $25.60 / $36.52	Facility		$6.23	$25.60	$36.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6.05 / $6.29 / $20.49	Professional		$6.05	$6.29	$20.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7.56 / $7.56 / $7.56	Facility		$7.56	$7.56	$7.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.05 / $6.05 / $9.36	Professional		$6.05	$6.05	$9.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.27 / $8.27 / $9.68	Facility		$8.27	$8.27	$9.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6.05 / $42.80 / $61.18	Facility		$6.05	$42.80	$61.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6.05 / $23.11 / $26.26	Professional		$6.05	$23.11	$26.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.05 / $12.80 / $13.55	Facility		$6.05	$12.80	$13.55
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2.67 / $12.10 / $19.20	Professional		$2.67	$12.10	$19.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $9.27 / $12.80 / $77.94	Facility		$9.27	$12.80	$77.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.10 / $12.80 / $19.20	Professional		$12.10	$12.80	$19.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.57 / $65.00 / $85.00	Professional		$12.57	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.05 / $12.80 / $13.55	Facility		$6.05	$12.80	$13.55
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2.67 / $12.10 / $19.20	Professional		$2.67	$12.10	$19.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.04 / $11.40 / $49.00	Professional		$6.04	$11.40	$49.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6.05 / $6.05 / $100.00	Facility		$6.05	$6.05	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.05 / $6.05 / $6.05	Professional		$6.05	$6.05	$6.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8.49 / $8.49 / $16.28	Professional		$8.49	$8.49	$16.28
United Facility/Professional Professional Modifier Low / Median / High Price $6.05 / $6.05 / $9.68	Professional		$6.05	$6.05	$9.68