Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.90 / $13.90 / $13.90	Facility		$13.90	$13.90	$13.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.16 / $13.90 / $24.99	Professional		$13.16	$13.90	$24.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.56 / $30.32 / $50.16	Facility		$27.56	$30.32	$50.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.80 / $25.63 / $33.89	Professional		$24.80	$25.63	$33.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.82 / $58.98 / $58.98	Facility		$19.82	$58.98	$58.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.39 / $61.12 / $114.76	Facility		$15.39	$61.12	$114.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.23 / $45.89 / $52.15	Professional		$11.23	$45.89	$52.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $7.93 / $20.85 / $31.69	Facility		$7.93	$20.85	$31.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $15.78 / $26.94 / $33.07	Professional		$15.78	$26.94	$33.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.74 / $27.56 / $128.41	Facility		$13.74	$27.56	$128.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.03 / $14.43 / $30.01	Professional		$12.03	$14.43	$30.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.56 / $55.00 / $85.00	Professional		$15.56	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $7.93 / $20.85 / $31.69	Facility		$7.93	$20.85	$31.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $15.78 / $26.94 / $33.07	Professional		$15.78	$26.94	$33.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $42.42 / $73.27	Professional		$27.56	$42.42	$73.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15.39 / $53.82 / $128.41	Facility		$15.39	$53.82	$128.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.23 / $15.39 / $138.63	Professional		$11.23	$15.39	$138.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $27.56 / $27.56	Professional		$27.56	$27.56	$27.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $27.56 / $27.56	Professional		$22.02	$27.56	$27.56
United Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $12.18 / $14.34	Facility		$0.02	$12.18	$14.34
United Facility/Professional Professional Modifier Low / Median / High Price $10.24 / $13.75 / $24.43	Professional		$10.24	$13.75	$24.43