Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.80 / $92.25 / $137.15	Facility		$73.80	$92.25	$137.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $57.81 / $135.08	Professional		$40.13	$57.81	$135.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.22 / $159.90 / $169.13	Facility		$132.22	$159.90	$169.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.60 / $24.60 / $250.88	Professional		$24.60	$24.60	$250.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.01 / $150.30 / $156.21	Facility		$37.01	$150.30	$156.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.41 / $197.97 / $303.69	Facility		$169.41	$197.97	$303.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.62 / $165.61 / $188.19	Professional		$70.62	$165.61	$188.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.60 / $33.06 / $73.80	Facility		$30.60	$33.06	$73.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.60 / $50.43 / $292.13	Facility		$30.60	$50.43	$292.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.05 / $48.00 / $110.70	Professional		$28.05	$48.00	$110.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.75 / $61.50 / $92.25	Professional		$30.75	$61.50	$92.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.60 / $33.06 / $73.80	Facility		$30.60	$33.06	$73.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $150.47 / $205.54	Professional		$72.20	$150.47	$205.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $123.00 / $123.00 / $292.13	Facility		$123.00	$123.00	$292.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.70 / $22.97 / $33.72	Professional		$22.70	$22.97	$33.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $54.18 / $130.97	Professional		$54.18	$54.18	$130.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $162.88 / $335.79	Professional		$54.18	$162.88	$335.79
United Facility/Professional Facility Modifier Low / Median / High Price $61.50 / $61.50 / $61.50	Facility		$61.50	$61.50	$61.50
United Facility/Professional Professional Modifier Low / Median / High Price $28.08 / $49.20 / $100.80	Professional		$28.08	$49.20	$100.80