Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.22 / $137.69 / $210.05	Facility		$31.22	$137.69	$210.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $20.81 / $28.57	Professional		$17.05	$20.81	$28.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.74 / $54.11 / $57.23	Facility		$44.74	$54.11	$57.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.28 / $10.28 / $86.10	Professional		$10.28	$10.28	$86.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.71 / $56.53 / $58.75	Facility		$16.71	$56.53	$58.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.81 / $20.81 / $20.81	Professional		$20.81	$20.81	$20.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $67.39 / $103.38	Facility		$57.67	$67.39	$103.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $56.03 / $63.68	Professional		$23.95	$56.03	$63.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.54 / $18.54 / $24.97	Facility		$18.54	$18.54	$24.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.54 / $20.99 / $154.04	Facility		$18.54	$20.99	$154.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $20.81 / $57.64	Professional		$12.49	$20.81	$57.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.41 / $55.00 / $85.00	Professional		$10.41	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.54 / $18.54 / $24.97	Facility		$18.54	$18.54	$24.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.44 / $50.69 / $73.45	Professional		$25.44	$50.69	$73.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $41.62 / $49.61 / $99.06	Facility		$41.62	$49.61	$99.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.03 / $13.72 / $20.39	Professional		$11.03	$13.72	$20.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.32 / $44.32 / $56.65	Professional		$44.32	$44.32	$56.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.65 / $98.68 / $113.62	Professional		$56.65	$98.68	$113.62
United Facility/Professional Professional Modifier Low / Median / High Price $12.07 / $17.44 / $57.64	Professional		$12.07	$17.44	$57.64