Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.03 / $76.23 / $263.19	Facility		$41.03	$76.23	$263.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.49 / $28.60 / $46.95	Professional		$27.49	$28.60	$46.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.51 / $88.89 / $94.02	Facility		$73.51	$88.89	$94.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.58 / $15.58 / $141.46	Professional		$15.58	$15.58	$141.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.93 / $85.68 / $89.05	Facility		$22.93	$85.68	$89.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.19 / $34.19 / $34.19	Professional		$34.19	$34.19	$34.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.72 / $109.52 / $168.00	Facility		$93.72	$109.52	$168.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $92.07 / $104.63	Professional		$39.24	$92.07	$104.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.10 / $28.10 / $41.03	Facility		$28.10	$28.10	$41.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.04 / $30.36 / $162.40	Facility		$28.04	$30.36	$162.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.51 / $34.19 / $92.57	Professional		$20.51	$34.19	$92.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.10 / $55.00 / $94.36	Professional		$17.10	$55.00	$94.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.10 / $28.10 / $41.03	Facility		$28.10	$28.10	$41.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $83.95 / $116.60	Professional		$40.28	$83.95	$116.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $68.38 / $68.38 / $162.40	Facility		$68.38	$68.38	$162.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.74 / $29.06 / $29.06	Professional		$20.74	$29.06	$29.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.81 / $72.81 / $97.85	Professional		$72.81	$72.81	$97.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.85 / $97.85 / $186.68	Professional		$97.85	$97.85	$186.68
United Facility/Professional Professional Modifier Low / Median / High Price $18.93 / $26.64 / $78.09	Professional		$18.93	$26.64	$78.09