Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.82 / $8.82 / $8.82	Facility		$8.82	$8.82	$8.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.82 / $13.95 / $43.50	Professional		$8.82	$13.95	$43.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.20 / $15.20 / $25.08	Facility		$15.20	$15.20	$25.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.14 / $15.20 / $17.32	Professional		$14.14	$15.20	$17.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.20 / $22.80 / $32.53	Facility		$15.20	$22.80	$32.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.96 / $18.23 / $35.25	Professional		$15.96	$18.23	$35.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.54 / $47.39 / $62.98	Facility		$40.54	$47.39	$62.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6.20 / $22.03 / $28.76	Professional		$6.20	$22.03	$28.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8.82 / $12.72 / $32.74	Facility		$8.82	$12.72	$32.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $15.20 / $15.20 / $24.32	Professional		$15.20	$15.20	$24.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $8.82 / $12.72 / $32.74	Facility		$8.82	$12.72	$32.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $7.01 / $8.58 / $25.28	Professional		$7.01	$8.58	$25.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.82 / $65.00 / $85.00	Professional		$8.82	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $8.82 / $12.72 / $32.74	Facility		$8.82	$12.72	$32.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $15.20 / $15.20 / $24.32	Professional		$15.20	$15.20	$24.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.20 / $22.80 / $39.00	Professional		$15.20	$22.80	$39.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $30.86 / $34.27 / $126.60	Facility		$30.86	$34.27	$126.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.20 / $66.78 / $293.29	Professional		$6.20	$66.78	$293.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $15.20 / $15.20 / $15.20	Professional		$15.20	$15.20	$15.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $15.20 / $15.20 / $41.00	Professional		$15.20	$15.20	$41.00
United Facility/Professional Professional Modifier Low / Median / High Price $6.44 / $7.57 / $14.16	Professional		$6.44	$7.57	$14.16