Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.28 / $84.14 / $218.00	Facility		$45.28	$84.14	$218.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $34.20 / $45.28	Professional		$33.61	$34.20	$45.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.12 / $98.10 / $103.76	Facility		$81.12	$98.10	$103.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.63 / $18.63 / $156.11	Professional		$18.63	$18.63	$156.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.28 / $102.45 / $106.48	Facility		$30.28	$102.45	$106.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $37.72 / $37.72	Professional		$37.72	$37.72	$37.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.63 / $121.10 / $185.77	Facility		$103.63	$121.10	$185.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.37 / $101.60 / $115.45	Professional		$43.37	$101.60	$115.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.60 / $33.60 / $45.28	Facility		$33.60	$33.60	$45.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.94 / $33.96 / $187.85	Facility		$30.94	$33.96	$187.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.13 / $37.72 / $104.51	Professional		$22.13	$37.72	$104.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.68 / $56.60 / $85.00	Professional		$18.68	$56.60	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.60 / $33.60 / $45.28	Facility		$33.60	$33.60	$45.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.11 / $92.66 / $146.38	Professional		$46.11	$92.66	$146.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.45 / $89.90 / $187.85	Facility		$75.45	$89.90	$187.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $24.82 / $36.85	Professional		$20.00	$24.82	$36.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.68 / $57.68 / $80.34	Professional		$57.68	$57.68	$80.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.68 / $57.68 / $206.01	Professional		$57.68	$57.68	$206.01
United Facility/Professional Facility Modifier Low / Median / High Price $33.54 / $33.54 / $90.97	Facility		$33.54	$33.54	$90.97
United Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $31.11 / $103.40	Professional		$20.00	$31.11	$103.40