Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $9.77 / $9.77	Facility		$9.77	$9.77	$9.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.75 / $9.77 / $12.82	Professional		$7.75	$9.77	$12.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.82 / $16.82 / $27.77	Facility		$16.82	$16.82	$27.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.65 / $16.82 / $19.18	Professional		$15.65	$16.82	$19.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.82 / $36.02 / $36.02	Facility		$16.82	$36.02	$36.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.06 / $52.65 / $69.98	Facility		$45.06	$52.65	$69.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6.87 / $24.38 / $31.86	Professional		$6.87	$24.38	$31.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $9.65 / $13.68 / $16.82	Facility		$9.65	$13.68	$16.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $10.69 / $10.69 / $16.82	Professional		$10.69	$10.69	$16.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $9.65 / $13.87 / $17.67	Facility		$9.65	$13.87	$17.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $9.51 / $35.76	Professional		$7.76	$9.51	$35.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $58.40 / $85.00	Professional		$9.77	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $9.65 / $13.87 / $16.82	Facility		$9.65	$13.87	$16.82
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $10.69 / $10.69 / $16.82	Professional		$10.69	$10.69	$16.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $25.25 / $44.00	Professional		$16.82	$25.25	$44.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $32.88 / $34.15 / $90.00	Facility		$32.88	$34.15	$90.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6.87 / $73.98 / $127.21	Professional		$6.87	$73.98	$127.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $16.82 / $16.82	Professional		$16.82	$16.82	$16.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $16.82 / $16.82	Professional		$16.82	$16.82	$16.82
United Facility/Professional Professional Modifier Low / Median / High Price $6.82 / $8.39 / $15.59	Professional		$6.82	$8.39	$15.59