Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.12 / $218.40 / $705.32	Facility		$109.12	$218.40	$705.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.14 / $74.04 / $111.57	Professional		$33.14	$74.04	$111.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.36 / $204.80 / $216.62	Facility		$169.36	$204.80	$216.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.51 / $31.51 / $315.08	Professional		$31.51	$31.51	$315.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.21 / $192.51 / $200.08	Facility		$45.21	$192.51	$200.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.77 / $78.77 / $78.77	Professional		$78.77	$78.77	$78.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $217.17 / $253.78 / $389.31	Facility		$217.17	$253.78	$389.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.86 / $143.19 / $241.04	Professional		$90.86	$143.19	$241.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.39 / $39.39 / $94.52	Facility		$39.39	$39.39	$94.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.39 / $82.50 / $374.16	Facility		$39.39	$82.50	$374.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.35 / $47.26 / $141.79	Professional		$23.35	$47.26	$141.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.99 / $65.00 / $100.16	Professional		$38.99	$65.00	$100.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.39 / $39.39 / $94.52	Facility		$39.39	$39.39	$94.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.72 / $188.20 / $263.95	Professional		$92.72	$188.20	$263.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $157.54 / $157.54 / $374.16	Facility		$157.54	$157.54	$374.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.78 / $18.98 / $27.70	Professional		$18.78	$18.98	$27.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $29.19 / $167.74	Professional		$29.19	$29.19	$167.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $29.19 / $430.08	Professional		$29.19	$29.19	$430.08
United Facility/Professional Professional Modifier Low / Median / High Price $23.41 / $47.26 / $141.79	Professional		$23.41	$47.26	$141.79