Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.98 / $12.98 / $12.98	Facility		$12.98	$12.98	$12.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $12.98 / $21.63	Professional		$10.72	$12.98	$21.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.73 / $28.30 / $46.83	Facility		$25.73	$28.30	$46.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.15 / $23.93 / $31.64	Professional		$23.15	$23.93	$31.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.51 / $55.06 / $55.06	Facility		$18.51	$55.06	$55.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.30 / $53.47 / $107.77	Facility		$16.30	$53.47	$107.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.91 / $37.50 / $48.70	Professional		$11.91	$37.50	$48.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8.27 / $19.47 / $29.59	Facility		$8.27	$19.47	$29.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.73 / $25.73 / $30.88	Professional		$14.73	$25.73	$30.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.98 / $25.73 / $134.22	Facility		$12.98	$25.73	$134.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.96 / $17.19 / $29.05	Professional		$11.96	$17.19	$29.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $55.00 / $85.00	Professional		$6.61	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $8.27 / $19.86 / $29.59	Facility		$8.27	$19.86	$29.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.73 / $25.73 / $30.88	Professional		$14.73	$25.73	$30.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.73 / $39.57 / $77.28	Professional		$25.73	$39.57	$77.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16.30 / $50.26 / $134.22	Facility		$16.30	$50.26	$134.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.91 / $16.30 / $161.27	Professional		$11.91	$16.30	$161.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.73 / $25.73 / $25.73	Professional		$25.73	$25.73	$25.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.73 / $25.73 / $25.73	Professional		$25.73	$25.73	$25.73
United Facility/Professional Professional Modifier Low / Median / High Price $10.25 / $15.44 / $25.73	Professional		$10.25	$15.44	$25.73