Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.12 / $14.12 / $14.12	Facility		$14.12	$14.12	$14.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.12 / $22.05 / $73.09	Professional		$14.12	$22.05	$73.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.31 / $24.31 / $40.11	Facility		$24.31	$24.31	$40.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.61 / $24.31 / $27.71	Professional		$22.61	$24.31	$27.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.31 / $36.47 / $52.02	Facility		$24.31	$36.47	$52.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.53 / $29.17 / $56.36	Professional		$25.53	$29.17	$56.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.78 / $76.87 / $102.17	Facility		$65.78	$76.87	$102.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.92 / $35.15 / $46.01	Professional		$9.92	$35.15	$46.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.12 / $20.36 / $46.64	Facility		$14.12	$20.36	$46.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $24.31 / $29.66	Professional		$24.31	$24.31	$29.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.12 / $20.36 / $46.64	Facility		$14.12	$20.36	$46.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $14.05 / $33.06	Professional		$11.22	$14.05	$33.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $58.40 / $85.00	Professional		$14.13	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.12 / $20.36 / $46.64	Facility		$14.12	$20.36	$46.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $24.31 / $29.66	Professional		$24.31	$24.31	$29.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $36.47 / $64.00	Professional		$24.31	$36.47	$64.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $47.48 / $49.35 / $154.32	Facility		$47.48	$49.35	$154.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $9.92 / $106.83 / $355.12	Professional		$9.92	$106.83	$355.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $24.31 / $24.31	Professional		$24.31	$24.31	$24.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $24.31 / $49.86	Professional		$24.31	$24.31	$49.86
United Facility/Professional Professional Modifier Low / Median / High Price $10.31 / $12.13 / $22.52	Professional		$10.31	$12.13	$22.52