Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.83 / $185.85 / $491.63	Facility		$78.83	$185.85	$491.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.57 / $61.75 / $310.00	Professional		$50.57	$61.75	$310.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.22 / $170.79 / $180.65	Facility		$141.22	$170.79	$180.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.28 / $65.69 / $281.35	Professional		$26.28	$65.69	$281.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.69 / $97.57 / $166.85	Facility		$65.69	$97.57	$166.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.69 / $68.97 / $84.90	Professional		$65.69	$68.97	$84.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.13 / $211.66 / $324.69	Facility		$181.13	$211.66	$324.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.58 / $176.89 / $201.01	Professional		$75.58	$176.89	$201.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.58 / $78.83 / $229.92	Facility		$50.58	$78.83	$229.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.12 / $88.68 / $360.00	Facility		$59.12	$88.68	$360.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.57 / $42.22 / $328.45	Professional		$33.57	$42.22	$328.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $50.58 / $78.83 / $229.92	Facility		$50.58	$78.83	$229.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.00 / $160.13 / $219.61	Professional		$128.00	$160.13	$219.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $131.38 / $312.02 / $312.02	Facility		$131.38	$312.02	$312.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.25 / $328.45 / $328.45	Professional		$95.25	$328.45	$328.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.63 / $50.63 / $139.88	Professional		$50.63	$50.63	$139.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.63 / $50.63 / $358.67	Professional		$50.63	$50.63	$358.67
United Facility/Professional Professional Modifier Low / Median / High Price $28.19 / $40.28 / $140.97	Professional		$28.19	$40.28	$140.97