Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.16 / $81.45 / $121.09	Facility		$65.16	$81.45	$121.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $55.66 / $65.16	Professional		$35.29	$55.66	$65.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.75 / $141.18 / $149.33	Facility		$116.75	$141.18	$149.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.72 / $21.72 / $221.51	Professional		$21.72	$21.72	$221.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.03 / $132.71 / $137.91	Facility		$49.03	$132.71	$137.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.59 / $174.80 / $268.14	Facility		$149.59	$174.80	$268.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.36 / $146.22 / $166.16	Professional		$62.36	$146.22	$166.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.15 / $54.30 / $200.00	Facility		$27.15	$54.30	$200.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.15 / $65.16 / $257.93	Facility		$27.15	$65.16	$257.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.49 / $54.30 / $114.03	Professional		$31.49	$54.30	$114.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $55.00 / $85.00	Professional		$26.88	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.15 / $54.30 / $200.00	Facility		$27.15	$54.30	$200.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $129.58 / $181.74	Professional		$63.84	$129.58	$181.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $108.60 / $108.60 / $257.93	Facility		$108.60	$108.60	$257.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.78 / $28.78 / $28.78	Professional		$28.78	$28.78	$28.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $115.63 / $115.63 / $115.63	Professional		$115.63	$115.63	$115.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.81 / $296.48 / $296.48	Professional		$157.81	$296.48	$296.48
United Facility/Professional Facility Modifier Low / Median / High Price $65.16 / $65.16 / $65.16	Facility		$65.16	$65.16	$65.16
United Facility/Professional Professional Modifier Low / Median / High Price $27.15 / $43.44 / $114.03	Professional		$27.15	$43.44	$114.03