Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $52.50 / $78.05	Facility		$42.00	$52.50	$78.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.95 / $33.25 / $53.20	Professional		$26.95	$33.25	$53.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.25 / $91.00 / $96.25	Facility		$75.25	$91.00	$96.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $35.00 / $149.91	Professional		$14.00	$35.00	$149.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.90 / $92.67 / $92.67	Facility		$88.90	$92.67	$92.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $112.67 / $172.85	Facility		$96.42	$112.67	$172.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.06 / $94.25 / $107.10	Professional		$40.06	$94.25	$107.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.95 / $42.00 / $122.50	Facility		$26.95	$42.00	$122.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.50 / $42.00 / $122.50	Facility		$31.50	$42.00	$122.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $21.00 / $107.93	Professional		$17.50	$21.00	$107.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $65.00 / $96.60	Professional		$35.00	$65.00	$96.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.95 / $42.00 / $122.50	Facility		$26.95	$42.00	$122.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.40 / $85.19 / $116.83	Professional		$66.40	$85.19	$116.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $166.25 / $166.25	Facility		$70.00	$166.25	$166.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.75 / $175.00 / $175.00	Professional		$50.75	$175.00	$175.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.53 / $74.53 / $74.53	Professional		$74.53	$74.53	$74.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $191.10 / $191.10	Professional		$101.72	$191.10	$191.10
United Facility/Professional Professional Modifier Low / Median / High Price $15.21 / $21.00 / $65.15	Professional		$15.21	$21.00	$65.15