Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.84 / $66.05 / $98.19	Facility		$52.84	$66.05	$98.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $41.83 / $70.98	Professional		$36.10	$41.83	$70.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.66 / $114.48 / $121.08	Facility		$94.66	$114.48	$121.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.61 / $17.61 / $176.12	Professional		$17.61	$17.61	$176.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.66 / $107.60 / $111.84	Facility		$25.66	$107.60	$111.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.75 / $141.11 / $216.46	Facility		$120.75	$141.11	$216.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $91.33 / $134.74	Professional		$50.39	$91.33	$134.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.02 / $22.02 / $52.84	Facility		$22.02	$22.02	$52.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.02 / $36.10 / $209.14	Facility		$22.02	$36.10	$209.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.89 / $26.42 / $79.25	Professional		$14.89	$26.42	$79.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $55.00 / $85.00	Professional		$22.02	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.02 / $22.02 / $52.84	Facility		$22.02	$22.02	$52.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.68 / $104.90 / $147.12	Professional		$51.68	$104.90	$147.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.06 / $88.06 / $209.14	Facility		$88.06	$88.06	$209.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.92 / $12.08 / $17.77	Professional		$11.92	$12.08	$17.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $18.57 / $93.76	Professional		$18.57	$18.57	$93.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $18.57 / $240.40	Professional		$18.57	$18.57	$240.40
United Facility/Professional Facility Modifier Low / Median / High Price $44.03 / $44.03 / $44.03	Facility		$44.03	$44.03	$44.03
United Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $26.42 / $79.25	Professional		$15.14	$26.42	$79.25