Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.55 / $15.55 / $15.55	Facility		$15.55	$15.55	$15.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $14.00 / $18.34	Professional		$9.77	$14.00	$18.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.40 / $42.59 / $42.59	Facility		$23.40	$42.59	$42.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.76 / $21.86 / $31.59	Professional		$21.76	$21.86	$31.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1.68 / $12.71 / $50.29	Facility		$1.68	$12.71	$50.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.44 / $14.44 / $63.08	Facility		$14.44	$14.44	$63.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.44 / $27.38 / $34.22	Professional		$14.44	$27.38	$34.22
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $7.47 / $18.80 / $27.99	Facility		$7.47	$18.80	$27.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $15.62 / $15.62 / $28.21	Professional		$15.62	$15.62	$28.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $7.47 / $28.21 / $109.75	Facility		$7.47	$28.21	$109.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $9.81 / $13.43 / $28.77	Professional		$9.81	$13.43	$28.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.81 / $50.00 / $65.00	Professional		$9.81	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $7.47 / $18.80 / $27.99	Facility		$7.47	$18.80	$27.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $15.62 / $15.62 / $28.21	Professional		$15.62	$15.62	$28.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $5.52 / $7.17	Professional		$3.09	$5.52	$7.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $14.44 / $45.66 / $109.75	Facility		$14.44	$45.66	$109.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.44 / $14.44 / $18.48	Professional		$14.44	$14.44	$18.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $23.50 / $23.50	Professional		$23.50	$23.50	$23.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $23.50 / $23.50	Professional		$23.50	$23.50	$23.50
United Facility/Professional Professional Modifier Low / Median / High Price $9.02 / $12.69 / $27.91	Professional		$9.02	$12.69	$27.91