Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $42.28 / $42.28	Facility		$42.28	$42.28	$42.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $42.28 / $42.28	Professional		$42.28	$42.28	$42.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.37 / $16.91 / $169.12	Professional		$14.37	$16.91	$169.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.28 / $64.47	Facility		$42.13	$42.28	$64.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.27 / $107.83 / $165.41	Facility		$92.27	$107.83	$165.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.57 / $113.85 / $129.38	Professional		$48.57	$113.85	$129.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $42.28 / $42.28	Facility		$42.28	$42.28	$42.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $42.28 / $200.83	Facility		$42.28	$42.28	$200.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.93 / $40.07 / $85.66	Professional		$22.93	$40.07	$85.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.93 / $55.00 / $85.00	Professional		$20.93	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $42.28 / $42.28	Facility		$42.28	$42.28	$42.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.78 / $101.04 / $144.10	Professional		$49.78	$101.04	$144.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $84.56 / $84.56 / $200.83	Facility		$84.56	$84.56	$200.83
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 $42.28 / $42.28 / $90.06	Professional		$42.28	$42.28	$90.06
Security Health Facility/Professional Facility Modifier Low / Median / High Price $50.74 / $50.74 / $50.74	Facility		$50.74	$50.74	$50.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $42.28 / $221.97	Professional		$42.28	$42.28	$221.97
United Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $42.28 / $42.28	Facility		$42.28	$42.28	$42.28
United Facility/Professional Professional Modifier Low / Median / High Price $21.14 / $25.37 / $78.70	Professional		$21.14	$25.37	$78.70