Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.63 / $40.63 / $40.63	Facility		$40.63	$40.63	$40.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.07 / $31.83 / $40.63	Professional		$26.07	$31.83	$40.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.80 / $88.04 / $93.12	Facility		$72.80	$88.04	$93.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $13.54 / $138.12	Professional		$13.54	$13.54	$138.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.68 / $82.75 / $82.75	Facility		$51.68	$82.75	$82.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.82 / $108.46 / $166.38	Facility		$92.82	$108.46	$166.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $91.18 / $103.61	Professional		$40.40	$91.18	$103.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.07 / $40.63 / $118.51	Facility		$26.07	$40.63	$118.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.47 / $40.63 / $118.51	Facility		$30.47	$40.63	$118.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.93 / $20.32 / $104.42	Professional		$16.93	$20.32	$104.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.07 / $40.63 / $118.51	Facility		$26.07	$40.63	$118.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.63 / $80.84 / $113.59	Professional		$49.63	$80.84	$113.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $67.72 / $160.84 / $160.84	Facility		$67.72	$160.84	$160.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.44 / $169.30 / $169.30	Professional		$135.44	$169.30	$169.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.11 / $72.11 / $72.11	Professional		$72.11	$72.11	$72.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $98.40 / $184.88 / $184.88	Professional		$98.40	$184.88	$184.88
United Facility/Professional Facility Modifier Low / Median / High Price $33.86 / $33.86 / $33.86	Facility		$33.86	$33.86	$33.86
United Facility/Professional Professional Modifier Low / Median / High Price $14.72 / $20.32 / $71.11	Professional		$14.72	$20.32	$71.11