Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.40 / $12.40 / $12.40	Facility		$12.40	$12.40	$12.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.96 / $12.40 / $45.00	Professional		$9.96	$12.40	$45.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.35 / $21.35 / $35.22	Facility		$21.35	$21.35	$35.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.86 / $21.35 / $24.33	Professional		$19.86	$21.35	$24.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.35 / $45.69 / $45.69	Facility		$21.35	$45.69	$45.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $67.39 / $89.57	Facility		$57.67	$67.39	$89.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $30.94 / $40.40	Professional		$8.71	$30.94	$40.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.24 / $17.57 / $21.35	Facility		$12.24	$17.57	$21.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $17.37 / $17.37 / $21.35	Professional		$17.37	$17.37	$21.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.40 / $17.57 / $22.42	Facility		$12.40	$17.57	$22.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $9.83 / $12.06 / $91.80	Professional		$9.83	$12.06	$91.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.38 / $65.00 / $85.00	Professional		$12.38	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.24 / $17.57 / $21.35	Facility		$12.24	$17.57	$21.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $17.37 / $17.37 / $21.35	Professional		$17.37	$17.37	$21.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $32.03 / $56.00	Professional		$21.35	$32.03	$56.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $41.70 / $43.34 / $99.92	Facility		$41.70	$43.34	$99.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $93.83 / $210.25	Professional		$8.71	$93.83	$210.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $21.35 / $21.35	Professional		$21.35	$21.35	$21.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $21.35 / $29.36	Professional		$21.35	$21.35	$29.36
United Facility/Professional Professional Modifier Low / Median / High Price $8.96 / $10.64 / $19.75	Professional		$8.96	$10.64	$19.75