Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $10.47 / $10.47	Facility		$10.47	$10.47	$10.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.20 / $10.47 / $15.44	Professional		$7.20	$10.47	$15.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.03 / $18.03 / $29.75	Facility		$18.03	$18.03	$29.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.77 / $18.03 / $20.55	Professional		$16.77	$18.03	$20.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.03 / $38.58 / $38.58	Facility		$18.03	$38.58	$38.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.66 / $56.86 / $75.58	Facility		$48.66	$56.86	$75.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.36 / $26.25 / $34.13	Professional		$7.36	$26.25	$34.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.34 / $14.86 / $18.03	Facility		$10.34	$14.86	$18.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $12.56 / $12.56 / $18.03	Professional		$12.56	$12.56	$18.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.34 / $14.86 / $18.93	Facility		$10.34	$14.86	$18.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $9.93 / $22.84	Professional		$8.32	$9.93	$22.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.48 / $58.40 / $85.00	Professional		$10.48	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.34 / $14.86 / $18.03	Facility		$10.34	$14.86	$18.03
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $12.56 / $12.56 / $18.03	Professional		$12.56	$12.56	$18.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.03 / $27.05 / $46.00	Professional		$18.03	$27.05	$46.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $35.22 / $36.60 / $90.00	Facility		$35.22	$36.60	$90.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.36 / $79.25 / $151.96	Professional		$7.36	$79.25	$151.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $18.03 / $18.03 / $18.03	Professional		$18.03	$18.03	$18.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $18.03 / $18.03 / $18.03	Professional		$18.03	$18.03	$18.03
United Facility/Professional Professional Modifier Low / Median / High Price $6.37 / $8.99 / $14.99	Professional		$6.37	$8.99	$14.99