Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Facility		$42.13	$42.13	$42.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Professional		$42.13	$42.13	$42.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.57 / $35.38 / $205.72	Professional		$20.57	$35.38	$205.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.99 / $51.43 / $78.26	Facility		$28.99	$51.43	$78.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.91 / $107.41 / $164.77	Facility		$91.91	$107.41	$164.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.10 / $138.49 / $157.38	Professional		$59.10	$138.49	$157.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.31 / $51.43	Facility		$42.13	$42.31	$51.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.31 / $244.29	Facility		$42.13	$42.31	$244.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.98 / $40.07 / $85.66	Professional		$22.98	$40.07	$85.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.46 / $55.00 / $85.00	Professional		$25.46	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.31 / $51.43	Facility		$42.13	$42.31	$51.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $122.43 / $174.90	Professional		$60.42	$122.43	$174.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $102.86 / $102.86 / $244.29	Facility		$102.86	$102.86	$244.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.71 / $28.71 / $28.71	Professional		$28.71	$28.71	$28.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $109.55	Professional		$42.13	$42.13	$109.55
Security Health Facility/Professional Facility Modifier Low / Median / High Price $50.56 / $50.56 / $50.56	Facility		$50.56	$50.56	$50.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $270.01	Professional		$42.13	$42.13	$270.01
United Facility/Professional Facility Modifier Low / Median / High Price $51.43 / $51.43 / $51.43	Facility		$51.43	$51.43	$51.43
United Facility/Professional Professional Modifier Low / Median / High Price $21.79 / $32.06 / $95.73	Professional		$21.79	$32.06	$95.73