Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.54 / $56.79 / $353.71	Facility		$30.54	$56.79	$353.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.34 / $20.84 / $30.54	Professional		$10.34	$20.84	$30.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.72 / $66.17 / $69.98	Facility		$54.72	$66.17	$69.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.18 / $14.46 / $103.82	Professional		$10.18	$14.46	$103.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.45 / $26.72 / $64.64	Facility		$25.45	$26.72	$64.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $25.45 / $25.45	Professional		$25.45	$25.45	$25.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.29 / $82.14 / $126.00	Facility		$70.29	$82.14	$126.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.32 / $47.69 / $77.88	Professional		$29.32	$47.69	$77.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.23 / $13.23 / $30.54	Facility		$13.23	$13.23	$30.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.23 / $30.54 / $129.59	Facility		$13.23	$30.54	$129.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.97 / $20.36 / $53.45	Professional		$13.97	$20.36	$53.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.60 / $25.45 / $85.00	Professional		$12.60	$25.45	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.23 / $13.23 / $30.54	Facility		$13.23	$13.23	$30.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $60.93 / $86.90	Professional		$33.95	$60.93	$86.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.90 / $60.64 / $120.89	Facility		$50.90	$60.64	$120.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.42 / $12.42 / $13.49	Professional		$12.42	$12.42	$13.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $25.45 / $54.20	Professional		$25.45	$25.45	$54.20
Security Health Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $153.46 / $175.35	Facility		$127.50	$153.46	$175.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $73.95 / $138.96	Professional		$25.45	$73.95	$138.96
United Facility/Professional Professional Modifier Low / Median / High Price $12.73 / $20.36 / $53.45	Professional		$12.73	$20.36	$53.45