Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.30 / $14.30 / $14.30	Facility		$14.30	$14.30	$14.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.55 / $14.30 / $25.73	Professional		$13.55	$14.30	$25.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.34 / $31.17 / $51.58	Facility		$28.34	$31.17	$51.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $26.36 / $34.85	Professional		$26.36	$26.36	$34.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.39 / $60.65 / $60.65	Facility		$20.39	$60.65	$60.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.80 / $58.17 / $118.96	Facility		$15.80	$58.17	$118.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $41.25 / $53.65	Professional		$11.53	$41.25	$53.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8.15 / $21.45 / $32.59	Facility		$8.15	$21.45	$32.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $16.23 / $27.21 / $34.01	Professional		$16.23	$27.21	$34.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.10 / $28.34 / $131.74	Facility		$14.10	$28.34	$131.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.39 / $14.85 / $30.87	Professional		$12.39	$14.85	$30.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.30 / $55.00 / $85.00	Professional		$13.30	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $8.15 / $21.45 / $32.59	Facility		$8.15	$21.45	$32.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $16.23 / $27.21 / $34.01	Professional		$16.23	$27.21	$34.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $43.62 / $75.28	Professional		$28.34	$43.62	$75.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15.80 / $55.36 / $131.74	Facility		$15.80	$55.36	$131.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $15.80 / $141.22	Professional		$11.53	$15.80	$141.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $28.34 / $28.34	Professional		$28.34	$28.34	$28.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.64 / $28.34 / $28.34	Professional		$22.64	$28.34	$28.34
United Facility/Professional Professional Modifier Low / Median / High Price $10.51 / $14.71 / $25.13	Professional		$10.51	$14.71	$25.13