Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $66.90 / $66.90	Facility		$45.00	$66.90	$66.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.39 / $60.00 / $192.90	Professional		$47.39	$60.00	$192.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.50 / $78.00 / $82.50	Facility		$64.50	$78.00	$82.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $12.00 / $120.00	Professional		$12.00	$12.00	$120.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.53 / $73.31 / $76.20	Facility		$17.53	$73.31	$76.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.90 / $96.88 / $148.61	Facility		$82.90	$96.88	$148.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.69 / $60.01 / $91.80	Professional		$34.69	$60.01	$91.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.73 / $10.73 / $38.40	Facility		$10.73	$10.73	$38.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.73 / $11.60 / $142.50	Facility		$10.73	$11.60	$142.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $9.94 / $18.00 / $54.00	Professional		$9.94	$18.00	$54.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $42.53 / $85.00	Professional		$15.00	$42.53	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $10.73 / $10.73 / $38.40	Facility		$10.73	$10.73	$38.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.34 / $73.66 / $123.85	Professional		$35.34	$73.66	$123.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $60.00 / $142.50	Facility		$60.00	$60.00	$142.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $8.06 / $11.76	Professional		$8.00	$8.06	$11.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $63.89	Professional		$30.90	$30.90	$63.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $163.80	Professional		$30.90	$30.90	$163.80
United Facility/Professional Professional Modifier Low / Median / High Price $12.60 / $24.00 / $54.00	Professional		$12.60	$24.00	$54.00