Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.67 / $13.67 / $13.67	Facility		$13.67	$13.67	$13.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.37 / $13.67 / $24.95	Professional		$12.37	$13.67	$24.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.10 / $29.81 / $49.32	Facility		$27.10	$29.81	$49.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.43 / $25.20 / $33.33	Professional		$23.43	$25.20	$33.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $57.99 / $57.99	Facility		$19.50	$57.99	$57.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.89 / $56.29 / $113.36	Facility		$16.89	$56.29	$113.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $39.38 / $51.28	Professional		$12.34	$39.38	$51.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $20.51 / $31.17	Facility		$8.13	$20.51	$31.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $15.51 / $27.10 / $32.52	Professional		$15.51	$27.10	$32.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.67 / $27.10 / $134.69	Facility		$13.67	$27.10	$134.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.60 / $18.10 / $30.59	Professional		$12.60	$18.10	$30.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.44 / $55.00 / $85.00	Professional		$7.44	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $20.92 / $31.17	Facility		$8.13	$20.92	$31.17
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $15.51 / $27.10 / $32.52	Professional		$15.51	$27.10	$32.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $41.72 / $75.28	Professional		$27.10	$41.72	$75.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16.89 / $52.92 / $134.69	Facility		$16.89	$52.92	$134.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $16.89 / $166.57	Professional		$12.34	$16.89	$166.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $27.10 / $27.10	Professional		$27.10	$27.10	$27.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $27.10 / $27.10	Professional		$27.10	$27.10	$27.10
United Facility/Professional Professional Modifier Low / Median / High Price $10.49 / $17.85 / $24.02	Professional		$10.49	$17.85	$24.02