Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $93.95	Facility		$42.13	$42.13	$93.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Professional		$42.13	$42.13	$42.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.85 / $16.85 / $171.85	Professional		$16.85	$16.85	$171.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $107.01	Facility		$42.13	$42.13	$107.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.91 / $107.41 / $164.77	Facility		$91.91	$107.41	$164.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $113.44 / $128.91	Professional		$48.40	$113.44	$128.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Facility		$42.13	$42.13	$42.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $200.12	Facility		$42.13	$42.13	$200.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.93 / $40.07 / $85.66	Professional		$22.93	$40.07	$85.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.85 / $50.00 / $85.00	Professional		$20.85	$50.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Facility		$42.13	$42.13	$42.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.87 / $100.27 / $143.00	Professional		$55.87	$100.27	$143.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $84.26 / $84.26 / $200.12	Facility		$84.26	$84.26	$200.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.07 / $28.71 / $28.71	Professional		$21.07	$28.71	$28.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $89.74 / $89.74 / $89.74	Professional		$89.74	$89.74	$89.74
Security Health Facility/Professional Facility Modifier Low / Median / High Price $50.56 / $50.56 / $50.56	Facility		$50.56	$50.56	$50.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $221.18 / $230.03	Professional		$42.13	$221.18	$230.03
United Facility/Professional Professional Modifier Low / Median / High Price $21.79 / $32.06 / $85.66	Professional		$21.79	$32.06	$85.66