Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $90.00 / $133.80	Facility		$72.00	$90.00	$133.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.20 / $57.00 / $72.00	Professional		$49.20	$57.00	$72.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $129.00 / $156.00 / $165.00	Facility		$129.00	$156.00	$165.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $24.00 / $240.00	Professional		$24.00	$24.00	$240.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.36 / $146.63 / $152.40	Facility		$27.36	$146.63	$152.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.91 / $192.70 / $295.61	Facility		$164.91	$192.70	$295.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.97 / $86.21 / $183.60	Professional		$68.97	$86.21	$183.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.92 / $16.12 / $72.00	Facility		$14.92	$16.12	$72.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.92 / $49.20 / $285.00	Facility		$14.92	$49.20	$285.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.82 / $36.00 / $108.00	Professional		$13.82	$36.00	$108.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $55.00 / $85.00	Professional		$29.70	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.92 / $16.12 / $72.00	Facility		$14.92	$16.12	$72.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.30 / $142.69 / $200.13	Professional		$70.30	$142.69	$200.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $285.00	Facility		$120.00	$120.00	$285.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.11 / $11.20 / $16.47	Professional		$11.11	$11.20	$16.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.23 / $17.23 / $127.77	Professional		$17.23	$17.23	$127.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $17.23 / $17.23 / $327.60	Professional		$17.23	$17.23	$327.60
United Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Facility		$60.00	$60.00	$60.00
United Facility/Professional Professional Modifier Low / Median / High Price $14.14 / $36.00 / $108.00	Professional		$14.14	$36.00	$108.00