Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.33 / $105.33 / $177.53	Facility		$105.33	$105.33	$177.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $105.33 / $105.33	Professional		$105.33	$105.33	$105.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.00 / $48.56 / $318.44	Professional		$6.00	$48.56	$318.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.61 / $79.61 / $202.21	Facility		$79.61	$79.61	$202.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.79 / $268.52 / $411.92	Facility		$229.79	$268.52	$411.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.48 / $214.38 / $243.61	Professional		$91.48	$214.38	$243.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $79.61 / $105.33 / $105.33	Facility		$79.61	$105.33	$105.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.61 / $105.33 / $378.15	Facility		$79.61	$105.33	$378.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.77 / $80.01 / $213.80	Professional		$47.77	$80.01	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $79.61 / $219.80	Professional		$39.40	$79.61	$219.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $79.61 / $105.33 / $105.33	Facility		$79.61	$105.33	$105.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.73 / $194.04 / $270.60	Professional		$105.73	$194.04	$270.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $159.22 / $159.22 / $378.15	Facility		$159.22	$159.22	$378.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.66 / $71.66 / $71.66	Professional		$71.66	$71.66	$71.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $105.33 / $169.57	Professional		$105.33	$105.33	$169.57
Security Health Facility/Professional Facility Modifier Low / Median / High Price $126.40 / $126.40 / $126.40	Facility		$126.40	$126.40	$126.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $417.95 / $417.95	Professional		$105.33	$417.95	$417.95
United Facility/Professional Facility Modifier Low / Median / High Price $79.61 / $79.61 / $79.61	Facility		$79.61	$79.61	$79.61
United Facility/Professional Professional Modifier Low / Median / High Price $46.17 / $79.61 / $266.80	Professional		$46.17	$79.61	$266.80