Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.93 / $14.93 / $14.93	Facility		$14.93	$14.93	$14.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.93 / $17.48 / $62.00	Professional		$14.93	$17.48	$62.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.72 / $25.72 / $42.44	Facility		$25.72	$25.72	$42.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.92 / $25.72 / $29.32	Professional		$23.92	$25.72	$29.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.72 / $55.04 / $55.04	Facility		$25.72	$55.04	$55.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.39 / $81.08 / $107.77	Facility		$69.39	$81.08	$107.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.49 / $37.50 / $48.69	Professional		$10.49	$37.50	$48.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.76 / $21.20 / $27.01	Facility		$14.76	$21.20	$27.01
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $25.72 / $30.46	Professional		$25.72	$25.72	$30.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.93 / $21.20 / $37.04	Facility		$14.93	$21.20	$37.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.86 / $14.54 / $32.59	Professional		$11.86	$14.54	$32.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.95 / $58.40 / $85.00	Professional		$14.95	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.76 / $21.20 / $27.01	Facility		$14.76	$21.20	$27.01
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $25.72 / $30.46	Professional		$25.72	$25.72	$30.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $38.58 / $68.00	Professional		$25.72	$38.58	$68.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.24 / $52.21 / $158.72	Facility		$50.24	$52.21	$158.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.49 / $113.04 / $365.74	Professional		$10.49	$113.04	$365.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $25.72 / $25.72	Professional		$25.72	$25.72	$25.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $25.72 / $51.34	Professional		$25.72	$25.72	$51.34
United Facility/Professional Professional Modifier Low / Median / High Price $10.81 / $12.83 / $23.97	Professional		$10.81	$12.83	$23.97