Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.92 / $69.90 / $103.92	Facility		$55.92	$69.90	$103.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $44.27 / $80.33	Professional		$35.88	$44.27	$80.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.19 / $121.16 / $128.15	Facility		$100.19	$121.16	$128.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.14 / $46.60 / $199.59	Professional		$21.14	$46.60	$199.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $116.24 / $116.24 / $120.80	Facility		$116.24	$116.24	$120.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.96 / $149.53 / $229.38	Facility		$127.96	$149.53	$229.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.69 / $125.49 / $142.60	Professional		$53.69	$125.49	$142.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $35.88 / $55.92 / $163.10	Facility		$35.88	$55.92	$163.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.94 / $55.92 / $163.10	Facility		$41.94	$55.92	$163.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.60 / $31.71 / $162.97	Professional		$25.60	$31.71	$162.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.60 / $65.00 / $128.62	Professional		$46.60	$65.00	$128.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $35.88 / $55.92 / $163.10	Facility		$35.88	$55.92	$163.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.60 / $113.59 / $158.40	Professional		$93.60	$113.59	$158.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $93.20 / $221.35 / $221.35	Facility		$93.20	$221.35	$221.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $233.00 / $233.00	Professional		$67.56	$233.00	$233.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $99.24 / $99.24 / $99.24	Professional		$99.24	$99.24	$99.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $135.43 / $254.44 / $254.44	Professional		$135.43	$254.44	$254.44
United Facility/Professional Facility Modifier Low / Median / High Price $46.60 / $46.60 / $46.60	Facility		$46.60	$46.60	$46.60
United Facility/Professional Professional Modifier Low / Median / High Price $22.20 / $31.71 / $110.99	Professional		$22.20	$31.71	$110.99