Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.70 / $12.70 / $12.70	Facility		$12.70	$12.70	$12.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.46 / $12.70 / $25.29	Professional		$12.46	$12.70	$25.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.18 / $27.70 / $45.83	Facility		$25.18	$27.70	$45.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.66 / $23.42 / $30.97	Professional		$22.66	$23.42	$30.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.12 / $53.89 / $53.89	Facility		$18.12	$53.89	$53.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.29 / $51.60 / $104.97	Facility		$16.29	$51.60	$104.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.89 / $41.93 / $47.65	Professional		$11.89	$41.93	$47.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $7.52 / $19.05 / $28.96	Facility		$7.52	$19.05	$28.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.42 / $25.18 / $31.12	Professional		$14.42	$25.18	$31.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.70 / $25.18 / $125.14	Facility		$12.70	$25.18	$125.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.70 / $16.82 / $28.43	Professional		$11.70	$16.82	$28.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.94 / $55.00 / $85.00	Professional		$13.94	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $7.52 / $19.05 / $28.96	Facility		$7.52	$19.05	$28.96
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.42 / $25.18 / $31.12	Professional		$14.42	$25.18	$31.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.18 / $38.74 / $70.26	Professional		$25.18	$38.74	$70.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16.29 / $49.18 / $125.14	Facility		$16.29	$49.18	$125.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.89 / $16.29 / $149.38	Professional		$11.89	$16.29	$149.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.18 / $25.18 / $25.18	Professional		$25.18	$25.18	$25.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.10 / $25.18 / $25.18	Professional		$20.10	$25.18	$25.18
United Facility/Professional Facility Modifier Low / Median / High Price $37.34 / $37.34 / $37.34	Facility		$37.34	$37.34	$37.34
United Facility/Professional Professional Modifier Low / Median / High Price $9.71 / $15.11 / $21.59	Professional		$9.71	$15.11	$21.59