Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $93.15 / $248.00	Facility		$50.12	$93.15	$248.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.25 / $34.25 / $94.56	Professional		$22.25	$34.25	$94.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.81 / $108.60 / $114.87	Facility		$89.81	$108.60	$114.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.71 / $16.71 / $170.39	Professional		$16.71	$16.71	$170.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.43 / $102.08 / $106.10	Facility		$26.43	$102.08	$106.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.34 / $134.79 / $206.77	Facility		$115.34	$134.79	$206.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.91 / $112.48 / $127.81	Professional		$47.91	$112.48	$127.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.23 / $24.02 / $50.12	Facility		$22.23	$24.02	$50.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.23 / $34.25 / $275.00	Facility		$22.23	$34.25	$275.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.54 / $33.42 / $75.19	Professional		$20.54	$33.42	$75.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $55.00 / $85.00	Professional		$20.89	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.23 / $24.02 / $50.12	Facility		$22.23	$24.02	$50.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.02 / $102.17 / $252.56	Professional		$49.02	$102.17	$252.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.54 / $83.54 / $275.00	Facility		$83.54	$83.54	$275.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.48 / $16.68 / $24.31	Professional		$16.48	$16.68	$24.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.67 / $25.67 / $88.95	Professional		$25.67	$25.67	$88.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.67 / $125.87 / $228.06	Professional		$25.67	$125.87	$228.06
United Facility/Professional Professional Modifier Low / Median / High Price $20.54 / $27.38 / $75.19	Professional		$20.54	$27.38	$75.19