Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.55 / $49.55 / $49.55	Professional		$49.55	$49.55	$49.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.97 / $4.97 / $215.02	Professional		$4.97	$4.97	$215.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.71 / $52.71 / $80.23	Facility		$52.71	$52.71	$80.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.08 / $169.54 / $260.08	Facility		$145.08	$169.54	$260.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.71 / $141.93 / $161.29	Professional		$60.71	$141.93	$161.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.41 / $47.44 / $67.47	Facility		$27.41	$47.44	$67.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.41 / $52.71 / $250.37	Facility		$27.41	$52.71	$250.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.57 / $52.71 / $110.69	Professional		$30.57	$52.71	$110.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $85.00 / $85.00	Professional		$26.36	$85.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.41 / $47.44 / $67.47	Facility		$27.41	$47.44	$67.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.94 / $125.72 / $179.30	Professional		$61.94	$125.72	$179.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $105.42 / $105.42 / $250.37	Facility		$105.42	$105.42	$250.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $27.94 / $27.94	Professional		$27.94	$27.94	$27.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.25 / $112.25 / $112.25	Professional		$112.25	$112.25	$112.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $287.80 / $287.80 / $287.80	Professional		$287.80	$287.80	$287.80
United Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $42.17 / $110.69	Professional		$26.36	$42.17	$110.69