Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.50 / $14.50 / $14.50	Facility		$14.50	$14.50	$14.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.51 / $14.50 / $19.02	Professional		$11.51	$14.50	$19.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.98 / $24.98 / $41.22	Facility		$24.98	$24.98	$41.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.23 / $24.98 / $28.47	Professional		$23.23	$24.98	$28.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.98 / $53.46 / $53.46	Facility		$24.98	$53.46	$53.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.68 / $77.92 / $103.57	Facility		$66.68	$77.92	$103.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $36.09 / $47.26	Professional		$10.19	$36.09	$47.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.33 / $20.30 / $24.98	Facility		$14.33	$20.30	$24.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $16.30 / $16.30 / $24.98	Professional		$16.30	$16.30	$24.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.33 / $20.58 / $26.23	Facility		$14.33	$20.58	$26.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.52 / $14.12 / $55.39	Professional		$11.52	$14.12	$55.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.51 / $65.00 / $85.00	Professional		$14.51	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.33 / $20.58 / $24.98	Facility		$14.33	$20.58	$24.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $16.30 / $16.30 / $24.98	Professional		$16.30	$16.30	$24.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $37.47 / $66.00	Professional		$24.98	$37.47	$66.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $48.78 / $50.71 / $116.91	Facility		$48.78	$50.71	$116.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $109.76 / $197.89	Professional		$10.19	$109.76	$197.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $24.98 / $24.98	Professional		$24.98	$24.98	$24.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $24.98 / $24.98	Professional		$24.98	$24.98	$24.98
United Facility/Professional Professional Modifier Low / Median / High Price $8.31 / $12.46 / $23.13	Professional		$8.31	$12.46	$23.13