Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.72 / $113.40 / $168.59	Facility		$90.72	$113.40	$168.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.21 / $71.06 / $90.72	Professional		$58.21	$71.06	$90.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.54 / $196.56 / $207.90	Facility		$162.54	$196.56	$207.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $46.11 / $302.39	Professional		$30.24	$46.11	$302.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.53 / $184.76 / $192.02	Facility		$39.53	$184.76	$192.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.16 / $243.25 / $373.15	Facility		$208.16	$243.25	$373.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $190.78 / $231.34	Professional		$87.14	$190.78	$231.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.51 / $68.04 / $148.63	Facility		$19.51	$68.04	$148.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.51 / $71.06 / $359.10	Facility		$19.51	$71.06	$359.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.96 / $45.36 / $209.41	Professional		$17.96	$45.36	$209.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.42 / $65.00 / $85.00	Professional		$37.42	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.51 / $68.04 / $148.63	Facility		$19.51	$68.04	$148.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.50 / $180.48 / $253.14	Professional		$57.50	$180.48	$253.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $151.19 / $151.19 / $359.10	Facility		$151.19	$151.19	$359.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.79 / $378.00 / $378.00	Professional		$36.79	$378.00	$378.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $22.63 / $160.99	Professional		$22.63	$22.63	$160.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $219.71 / $412.78	Professional		$22.63	$219.71	$412.78
United Facility/Professional Professional Modifier Low / Median / High Price $17.96 / $45.36 / $140.72	Professional		$17.96	$45.36	$140.72