Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.54 / $13.54 / $13.54	Facility		$13.54	$13.54	$13.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.75 / $56.00	Professional		$12.88	$15.75	$56.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.32 / $23.32 / $38.47	Facility		$23.32	$23.32	$38.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.69 / $23.32 / $26.58	Professional		$21.69	$23.32	$26.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.32 / $49.90 / $49.90	Facility		$23.32	$49.90	$49.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.08 / $73.70 / $97.97	Facility		$63.08	$73.70	$97.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.51 / $33.75 / $44.13	Professional		$9.51	$33.75	$44.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.54 / $19.53 / $45.64	Facility		$13.54	$19.53	$45.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $22.45 / $23.32	Professional		$22.45	$22.45	$23.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.54 / $19.53 / $45.64	Facility		$13.54	$19.53	$45.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.76 / $12.82 / $29.54	Professional		$10.76	$12.82	$29.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.55 / $65.00 / $85.00	Professional		$13.55	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.54 / $19.53 / $45.64	Facility		$13.54	$19.53	$45.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $22.45 / $23.32	Professional		$22.45	$22.45	$23.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $34.97 / $61.00	Professional		$23.32	$34.97	$61.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.54 / $47.34 / $117.78	Facility		$45.54	$47.34	$117.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $9.51 / $102.47 / $272.08	Professional		$9.51	$102.47	$272.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $23.32 / $23.32	Professional		$23.32	$23.32	$23.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $15.89 / $23.32 / $23.32	Professional		$15.89	$23.32	$23.32
United Facility/Professional Professional Modifier Low / Median / High Price $9.80 / $11.63 / $21.72	Professional		$9.80	$11.63	$21.72