Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.01 / $18.01 / $18.01	Facility		$18.01	$18.01	$18.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.01 / $19.84 / $42.93	Professional		$18.01	$19.84	$42.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.70 / $39.27 / $64.97	Facility		$35.70	$39.27	$64.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.87 / $33.20 / $43.91	Professional		$30.87	$33.20	$43.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.69 / $76.40 / $76.40	Facility		$25.69	$76.40	$76.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.10 / $74.11 / $148.35	Facility		$23.10	$74.11	$148.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.86 / $51.56 / $67.58	Professional		$16.86	$51.56	$67.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $11.50 / $27.02 / $41.06	Facility		$11.50	$27.02	$41.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $20.44 / $35.70 / $47.60	Professional		$20.44	$35.70	$47.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.01 / $35.69 / $190.57	Facility		$18.01	$35.69	$190.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.17 / $20.78 / $40.31	Professional		$16.17	$20.78	$40.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $55.00 / $85.00	Professional		$37.99	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $11.50 / $27.02 / $41.06	Facility		$11.50	$27.02	$41.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $20.44 / $35.70 / $47.60	Professional		$20.44	$35.70	$47.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.70 / $54.94 / $106.39	Professional		$35.70	$54.94	$106.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $23.10 / $69.73 / $190.57	Facility		$23.10	$69.73	$190.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.86 / $23.10 / $294.20	Professional		$16.86	$23.10	$294.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.70 / $35.70 / $35.70	Professional		$35.70	$35.70	$35.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.70 / $35.70 / $35.70	Professional		$35.70	$35.70	$35.70
United Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $19.01 / $34.57	Professional		$14.23	$19.01	$34.57