Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.38 / $14.38 / $14.38	Facility		$14.38	$14.38	$14.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.78 / $14.38 / $27.81	Professional		$13.78	$14.38	$27.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.52 / $31.37 / $51.91	Facility		$28.52	$31.37	$51.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.66 / $26.52 / $35.07	Professional		$25.66	$26.52	$35.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.52 / $61.03 / $61.03	Facility		$20.52	$61.03	$61.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.44 / $59.08 / $118.96	Facility		$18.44	$59.08	$118.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $41.25 / $53.98	Professional		$13.46	$41.25	$53.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8.55 / $21.57 / $32.79	Facility		$8.55	$21.57	$32.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $28.52 / $34.22	Professional		$16.32	$28.52	$34.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.38 / $28.52 / $140.91	Facility		$14.38	$28.52	$140.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.26 / $19.05 / $32.19	Professional		$13.26	$19.05	$32.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $55.00 / $85.00	Professional		$18.19	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $8.55 / $21.57 / $32.79	Facility		$8.55	$21.57	$32.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $28.52 / $34.22	Professional		$16.32	$28.52	$34.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $43.88 / $79.29	Professional		$28.52	$43.88	$79.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $18.44 / $55.70 / $140.91	Facility		$18.44	$55.70	$140.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $18.44 / $160.41	Professional		$13.46	$18.44	$160.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $28.52	Professional		$28.52	$28.52	$28.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $28.52 / $28.52	Professional		$22.77	$28.52	$28.52
United Facility/Professional Professional Modifier Low / Median / High Price $11.36 / $17.51 / $25.28	Professional		$11.36	$17.51	$25.28