Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.89 / $79.70 / $141.94	Facility		$42.89	$79.70	$141.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.31 / $33.95 / $105.25	Professional		$29.31	$33.95	$105.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.84 / $92.92 / $98.29	Facility		$76.84	$92.92	$98.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.30 / $14.30 / $145.79	Professional		$14.30	$14.30	$145.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.84 / $87.34 / $90.78	Facility		$23.84	$87.34	$90.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $35.74 / $35.74	Professional		$35.74	$35.74	$35.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.22 / $114.78 / $176.08	Facility		$98.22	$114.78	$176.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $96.24 / $109.36	Professional		$40.89	$96.24	$109.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.87 / $17.87 / $42.89	Facility		$17.87	$17.87	$42.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.87 / $29.31 / $169.77	Facility		$17.87	$29.31	$169.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.73 / $35.74 / $78.56	Professional		$20.73	$35.74	$78.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.87 / $53.61 / $85.00	Professional		$17.87	$53.61	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $17.87 / $17.87 / $42.89	Facility		$17.87	$17.87	$42.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.80 / $86.77 / $119.00	Professional		$41.80	$86.77	$119.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $71.48 / $71.48 / $169.77	Facility		$71.48	$71.48	$169.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $17.91 / $26.14	Professional		$17.64	$17.91	$26.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.55 / $27.55 / $76.11	Professional		$27.55	$27.55	$76.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.55 / $106.75 / $195.14	Professional		$27.55	$106.75	$195.14
United Facility/Professional Facility Modifier Low / Median / High Price $42.89 / $42.89 / $42.89	Facility		$42.89	$42.89	$42.89
United Facility/Professional Professional Modifier Low / Median / High Price $17.87 / $28.59 / $78.56	Professional		$17.87	$28.59	$78.56