Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.14 / $403.62 / $697.31	Facility		$72.14	$403.62	$697.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $39.06 / $57.16	Professional		$37.15	$39.06	$57.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.40 / $123.84 / $130.97	Facility		$102.40	$123.84	$130.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.52 / $29.05 / $197.07	Professional		$23.52	$29.05	$197.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.90 / $134.44 / $140.13	Facility		$29.90	$134.44	$140.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.63 / $47.63 / $47.63	Professional		$47.63	$47.63	$47.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.66 / $152.69 / $234.23	Facility		$130.66	$152.69	$234.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $128.26 / $145.75	Professional		$54.52	$128.26	$145.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.79 / $38.79 / $57.16	Facility		$38.79	$38.79	$57.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.79 / $57.16 / $475.58	Facility		$38.79	$57.16	$475.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $47.63 / $131.94	Professional		$28.58	$47.63	$131.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $55.00 / $93.39	Professional		$23.82	$55.00	$93.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $38.79 / $38.79 / $57.16	Facility		$38.79	$38.79	$57.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $116.42 / $183.67	Professional		$58.22	$116.42	$183.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $95.26 / $95.26 / $260.00	Facility		$95.26	$95.26	$260.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.24 / $32.17 / $53.06	Professional		$25.24	$32.17	$53.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $101.43 / $101.43 / $102.79	Professional		$101.43	$101.43	$102.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.79 / $102.79 / $260.06	Professional		$102.79	$102.79	$260.06
United Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $39.92 / $139.72	Professional		$27.63	$39.92	$139.72