Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.55 / $12.55 / $12.55	Facility		$12.55	$12.55	$12.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.78 / $12.55 / $21.75	Professional		$10.78	$12.55	$21.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.86 / $27.35 / $45.25	Facility		$24.86	$27.35	$45.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.37 / $23.12 / $30.57	Professional		$22.37	$23.12	$30.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.88 / $53.20 / $53.20	Facility		$17.88	$53.20	$53.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.62 / $51.60 / $103.57	Facility		$16.62	$51.60	$103.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.13 / $36.09 / $47.05	Professional		$12.13	$36.09	$47.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8.01 / $18.82 / $28.59	Facility		$8.01	$18.82	$28.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $24.86 / $32.49	Professional		$14.23	$24.86	$32.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.55 / $24.86 / $132.87	Facility		$12.55	$24.86	$132.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.56 / $16.61 / $28.07	Professional		$11.56	$16.61	$28.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.73 / $55.00 / $85.00	Professional		$10.73	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $8.01 / $19.20 / $28.59	Facility		$8.01	$19.20	$28.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $24.86 / $32.49	Professional		$14.23	$24.86	$32.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $38.26 / $74.27	Professional		$24.86	$38.26	$74.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16.62 / $48.56 / $132.87	Facility		$16.62	$48.56	$132.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.13 / $16.62 / $157.21	Professional		$12.13	$16.62	$157.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $24.86 / $24.86	Professional		$24.86	$24.86	$24.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $24.86 / $24.86	Professional		$24.86	$24.86	$24.86
United Facility/Professional Facility Modifier Low / Median / High Price $16.25 / $16.25 / $16.25	Facility		$16.25	$16.25	$16.25
United Facility/Professional Professional Modifier Low / Median / High Price $10.34 / $16.54 / $24.86	Professional		$10.34	$16.54	$24.86