Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.88 / $4.88 / $4.88	Facility		$4.88	$4.88	$4.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.88 / $6.58 / $22.50	Professional		$4.88	$6.58	$22.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.42 / $8.42 / $13.89	Facility		$8.42	$8.42	$13.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.83 / $8.42 / $9.59	Professional		$7.83	$8.42	$9.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.42 / $18.02 / $18.02	Facility		$8.42	$18.02	$18.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.53 / $26.33 / $34.99	Facility		$22.53	$26.33	$34.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.44 / $12.19 / $15.93	Professional		$3.44	$12.19	$15.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4.88 / $7.05 / $17.86	Facility		$4.88	$7.05	$17.86
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $8.42 / $8.42 / $11.49	Professional		$8.42	$8.42	$11.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $4.88 / $7.05 / $17.86	Facility		$4.88	$7.05	$17.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $3.88 / $4.76 / $38.28	Professional		$3.88	$4.76	$38.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.88 / $65.00 / $85.00	Professional		$4.88	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $4.88 / $7.05 / $17.86	Facility		$4.88	$7.05	$17.86
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $8.42 / $8.42 / $11.49	Professional		$8.42	$8.42	$11.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.42 / $12.63 / $21.00	Professional		$8.42	$12.63	$21.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16.44 / $17.09 / $90.00	Facility		$16.44	$17.09	$90.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3.44 / $36.99 / $137.82	Professional		$3.44	$36.99	$137.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8.42 / $8.42 / $8.42	Professional		$8.42	$8.42	$8.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8.42 / $8.42 / $19.20	Professional		$8.42	$8.42	$19.20
United Facility/Professional Professional Modifier Low / Median / High Price $3.57 / $4.20 / $8.05	Professional		$3.57	$4.20	$8.05