Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.13 / $181.44 / $432.18	Facility		$53.13	$181.44	$432.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $33.47 / $46.20	Professional		$31.57	$33.47	$46.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.78 / $100.10 / $105.88	Facility		$82.78	$100.10	$105.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.01 / $19.01 / $159.29	Professional		$19.01	$19.01	$159.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.27 / $104.55 / $108.66	Facility		$26.27	$104.55	$108.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.50 / $38.50 / $38.50	Professional		$38.50	$38.50	$38.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $124.26 / $190.61	Facility		$106.33	$124.26	$190.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.19 / $103.68 / $117.81	Professional		$44.19	$103.68	$117.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.29 / $34.29 / $46.20	Facility		$34.29	$34.29	$46.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.80 / $36.19 / $183.99	Facility		$30.80	$36.19	$183.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $38.50 / $106.65	Professional		$23.10	$38.50	$106.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.25 / $55.00 / $85.00	Professional		$19.25	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $34.29 / $34.29 / $46.20	Facility		$34.29	$34.29	$46.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $94.25 / $186.68	Professional		$51.98	$94.25	$186.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $77.00 / $77.00 / $183.99	Facility		$77.00	$77.00	$183.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.41 / $25.48 / $37.64	Professional		$20.41	$25.48	$37.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.36 / $56.36 / $81.99	Professional		$56.36	$56.36	$81.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.36 / $153.47 / $210.21	Professional		$56.36	$153.47	$210.21
United Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $32.27 / $106.65	Professional		$22.33	$32.27	$106.65