Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7.25 / $7.25 / $7.25	Facility		$7.25	$7.25	$7.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.94 / $7.25 / $10.72	Professional		$4.94	$7.25	$10.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.49 / $12.49 / $20.61	Facility		$12.49	$12.49	$20.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.62 / $12.49 / $14.23	Professional		$11.62	$12.49	$14.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.49 / $26.73 / $26.73	Facility		$12.49	$26.73	$26.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.34 / $38.96 / $51.78	Facility		$33.34	$38.96	$51.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5.09 / $18.28 / $23.64	Professional		$5.09	$18.28	$23.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $7.17 / $10.15 / $12.49	Facility		$7.17	$10.15	$12.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $8.27 / $8.27 / $12.49	Professional		$8.27	$8.27	$12.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $7.17 / $10.30 / $13.11	Facility		$7.17	$10.30	$13.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $5.77 / $7.06 / $27.70	Professional		$5.77	$7.06	$27.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.25 / $65.00 / $85.00	Professional		$7.25	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $7.17 / $10.30 / $12.49	Facility		$7.17	$10.30	$12.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $8.27 / $8.27 / $12.49	Professional		$8.27	$8.27	$12.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $18.73 / $33.00	Professional		$12.49	$18.73	$33.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $24.40 / $25.35 / $90.00	Facility		$24.40	$25.35	$90.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5.09 / $54.90 / $98.94	Professional		$5.09	$54.90	$98.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $12.49	Professional		$12.49	$12.49	$12.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $13.85	Professional		$12.49	$12.49	$13.85
United Facility/Professional Professional Modifier Low / Median / High Price $4.16 / $6.23 / $10.39	Professional		$4.16	$6.23	$10.39