Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $42.11 / $42.11	Facility		$42.11	$42.11	$42.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $32.97 / $42.11	Professional		$27.02	$32.97	$42.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.44 / $91.23 / $96.50	Facility		$75.44	$91.23	$96.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $19.10 / $143.13	Professional		$19.10	$19.10	$143.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.15 / $53.15 / $53.15	Facility		$53.15	$53.15	$53.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $112.67 / $172.85	Facility		$96.42	$112.67	$172.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.26 / $94.49 / $107.38	Professional		$41.26	$94.49	$107.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.02 / $42.11 / $122.82	Facility		$27.02	$42.11	$122.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.02 / $42.11 / $122.82	Facility		$27.02	$42.11	$122.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $21.05 / $108.21	Professional		$17.55	$21.05	$108.21
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 $27.02 / $42.11 / $122.82	Facility		$27.02	$42.11	$122.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.32 / $83.30 / $116.83	Professional		$58.32	$83.30	$116.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.18 / $166.68 / $166.68	Facility		$70.18	$166.68	$166.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.36 / $175.45 / $175.45	Professional		$140.36	$175.45	$175.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.73 / $74.73 / $74.73	Professional		$74.73	$74.73	$74.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $101.98 / $191.59 / $191.59	Professional		$101.98	$191.59	$191.59
United Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $42.11 / $42.11	Facility		$42.11	$42.11	$42.11
United Facility/Professional Professional Modifier Low / Median / High Price $15.79 / $21.05 / $65.31	Professional		$15.79	$21.05	$65.31