Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.10 / $66.38 / $98.68	Facility		$53.10	$66.38	$98.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.13 / $41.60 / $53.10	Professional		$22.13	$41.60	$53.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.14 / $115.05 / $121.69	Facility		$95.14	$115.05	$121.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.70 / $17.70 / $180.52	Professional		$17.70	$17.70	$180.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.30 / $108.15 / $112.40	Facility		$28.30	$108.15	$112.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.65 / $142.16 / $218.08	Facility		$121.65	$142.16	$218.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.80 / $119.15 / $135.40	Professional		$50.80	$119.15	$135.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.13 / $22.13 / $53.10	Facility		$22.13	$22.13	$53.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.13 / $36.29 / $210.19	Facility		$22.13	$36.29	$210.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.68 / $29.37 / $79.65	Professional		$10.68	$29.37	$79.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.90 / $55.00 / $85.00	Professional		$21.90	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.13 / $22.13 / $53.10	Facility		$22.13	$22.13	$53.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.59 / $105.67 / $148.21	Professional		$35.59	$105.67	$148.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.50 / $88.50 / $210.19	Facility		$88.50	$88.50	$210.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.49 / $23.45 / $23.45	Professional		$8.49	$23.45	$23.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $22.63 / $94.23	Professional		$22.63	$22.63	$94.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $88.58 / $241.61	Professional		$22.63	$88.58	$241.61
United Facility/Professional Professional Modifier Low / Median / High Price $17.80 / $30.17 / $79.65	Professional		$17.80	$30.17	$79.65