Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.30 / $122.44 / $219.45	Facility		$30.30	$122.44	$219.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.44 / $22.45 / $30.30	Professional		$19.44	$22.45	$30.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.29 / $65.65 / $69.44	Facility		$54.29	$65.65	$69.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.47 / $12.47 / $104.47	Professional		$12.47	$12.47	$104.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.23 / $68.56 / $71.27	Facility		$17.23	$68.56	$71.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.39 / $81.08 / $124.38	Facility		$69.39	$81.08	$124.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $67.98 / $77.26	Professional		$28.91	$67.98	$77.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.49 / $22.49 / $30.30	Facility		$22.49	$22.49	$30.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.71 / $22.73 / $120.30	Facility		$20.71	$22.73	$120.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $25.25 / $82.69	Professional		$15.15	$25.25	$82.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.63 / $49.49 / $85.00	Professional		$12.63	$49.49	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.49 / $22.49 / $30.30	Facility		$22.49	$22.49	$30.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.87 / $61.78 / $164.71	Professional		$30.87	$61.78	$164.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $50.50 / $120.30	Facility		$50.50	$50.50	$120.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.38 / $16.66 / $24.57	Professional		$13.38	$16.66	$24.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $53.77 / $62.83	Professional		$53.77	$53.77	$62.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.83 / $119.74 / $137.87	Professional		$62.83	$119.74	$137.87
United Facility/Professional Professional Modifier Low / Median / High Price $14.65 / $21.32 / $69.20	Professional		$14.65	$21.32	$69.20