Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.87 / $12.87 / $12.87	Facility		$12.87	$12.87	$12.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.87 / $13.74	Professional		$12.49	$12.87	$13.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $18.73	Professional		$12.49	$12.49	$18.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.10 / $19.98 / $30.73	Facility		$17.10	$19.98	$30.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.85 / $30.82 / $43.68	Facility		$16.85	$30.82	$43.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $15.98 / $23.03	Professional		$12.49	$15.98	$23.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $8.78 / $12.49 / $19.18	Facility		$8.78	$12.49	$19.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $8.78 / $12.75 / $19.51	Facility		$8.78	$12.75	$19.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.38 / $12.38 / $26.00	Professional		$12.38	$12.38	$26.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.57 / $58.40 / $85.00	Professional		$30.57	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $8.78 / $12.49 / $19.18	Facility		$8.78	$12.49	$19.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $14.43 / $30.89	Professional		$12.49	$14.43	$30.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $85.00 / $100.00	Facility		$65.00	$85.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $17.66 / $6,184.50	Professional		$12.49	$17.66	$6,184.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.54 / $17.54 / $17.54	Professional		$17.54	$17.54	$17.54
United Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $17.10	Professional		$12.49	$12.49	$17.10