Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.30 / $20.30 / $20.30	Facility		$20.30	$20.30	$20.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.22 / $18.07 / $22.92	Professional		$12.22	$18.07	$22.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $54.60 / $54.60	Facility		$30.00	$54.60	$54.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.13 / $27.90 / $37.50	Professional		$23.13	$27.90	$37.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.36 / $17.64 / $64.20	Facility		$2.36	$17.64	$64.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.13 / $20.13 / $79.30	Facility		$20.13	$20.13	$79.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.11 / $34.13 / $42.66	Professional		$17.11	$34.13	$42.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.41 / $25.46 / $37.69	Facility		$10.41	$25.46	$37.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $21.13 / $21.13 / $39.32	Professional		$21.13	$21.13	$39.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.41 / $39.32 / $134.91	Facility		$10.41	$39.32	$134.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.57 / $18.11 / $35.63	Professional		$13.57	$18.11	$35.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.55 / $50.00 / $65.00	Professional		$11.55	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.41 / $26.22 / $37.69	Facility		$10.41	$26.22	$37.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $21.13 / $21.13 / $39.32	Professional		$21.13	$21.13	$39.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3.96 / $6.31 / $8.19	Professional		$3.96	$6.31	$8.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $20.13 / $58.26 / $134.91	Facility		$20.13	$58.26	$134.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.13 / $20.13 / $22.20	Professional		$20.13	$20.13	$22.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $32.08 / $32.08	Professional		$32.08	$32.08	$32.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $32.08 / $32.08	Professional		$32.08	$32.08	$32.08
United Facility/Professional Professional Modifier Low / Median / High Price $11.31 / $17.67 / $33.92	Professional		$11.31	$17.67	$33.92