Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $55.75	Facility		$30.00	$30.00	$55.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $23.50 / $30.00	Professional		$20.50	$23.50	$30.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.75 / $65.00 / $68.75	Facility		$53.75	$65.00	$68.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $100.00	Professional		$10.00	$10.00	$100.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.28 / $61.10 / $63.50	Facility		$18.28	$61.10	$63.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $80.03 / $122.77	Facility		$68.48	$80.03	$122.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $32.34 / $76.50	Professional		$13.15	$32.34	$76.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.50 / $22.50 / $32.00	Facility		$12.50	$22.50	$32.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $11.06 / $11.06 / $11.06	Professional		$11.06	$11.06	$11.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.50 / $25.00 / $118.75	Facility		$12.50	$25.00	$118.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $7.64 / $25.00 / $45.00	Professional		$7.64	$25.00	$45.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.38 / $37.50 / $85.00	Professional		$12.38	$37.50	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.50 / $22.50 / $32.00	Facility		$12.50	$22.50	$32.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $11.06 / $11.06 / $11.06	Professional		$11.06	$11.06	$11.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $60.74 / $84.70	Professional		$27.70	$60.74	$84.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $118.75	Facility		$50.00	$50.00	$118.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.70 / $13.15 / $13.15	Professional		$6.70	$13.15	$13.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5.73 / $5.73 / $34.28	Professional		$5.73	$5.73	$34.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.20 / $174.46 / $174.46	Professional		$22.20	$174.46	$174.46
United Facility/Professional Professional Modifier Low / Median / High Price $7.78 / $20.00 / $45.00	Professional		$7.78	$20.00	$45.00