Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.35 / $13.35 / $13.35	Facility		$13.35	$13.35	$13.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.42 / $12.01 / $15.80	Professional		$8.42	$12.01	$15.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.10 / $36.58 / $36.58	Facility		$20.10	$36.58	$36.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.64 / $18.69 / $27.05	Professional		$18.64	$18.69	$27.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1.44 / $14.33 / $42.89	Facility		$1.44	$14.33	$42.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.24 / $13.24 / $54.07	Facility		$13.24	$13.24	$54.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.24 / $23.25 / $29.06	Professional		$13.24	$23.25	$29.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.36 / $16.04 / $24.03	Facility		$6.36	$16.04	$24.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $13.31 / $13.31 / $24.06	Professional		$13.31	$13.31	$24.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $6.36 / $24.06 / $93.55	Facility		$6.36	$24.06	$93.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.35 / $11.47 / $24.59	Professional		$8.35	$11.47	$24.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.35 / $50.00 / $65.00	Professional		$8.35	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.36 / $16.04 / $24.03	Facility		$6.36	$16.04	$24.03
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $13.31 / $13.31 / $24.06	Professional		$13.31	$13.31	$24.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2.65 / $4.73 / $6.15	Professional		$2.65	$4.73	$6.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13.24 / $39.14 / $93.55	Facility		$13.24	$39.14	$93.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.24 / $13.24 / $15.97	Professional		$13.24	$13.24	$15.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.04 / $20.04 / $20.04	Professional		$20.04	$20.04	$20.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.04 / $20.04 / $20.04	Professional		$20.04	$20.04	$20.04
United Facility/Professional Professional Modifier Low / Median / High Price $7.99 / $11.74 / $24.04	Professional		$7.99	$11.74	$24.04