Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $93.95 / $231.30	Facility		$42.13	$93.95	$231.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $43.82 / $84.26	Professional		$42.13	$43.82	$84.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.85 / $28.98 / $171.85	Professional		$16.85	$28.98	$171.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.29 / $44.24 / $107.01	Facility		$35.29	$44.24	$107.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Professional		$42.13	$42.13	$42.13
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 $24.44 / $42.13 / $88.47	Professional		$24.44	$42.13	$88.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.85 / $35.92 / $85.00	Professional		$20.85	$35.92	$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 $30.12 / $100.27 / $143.00	Professional		$30.12	$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 / $28.65 / $28.65	Professional		$21.07	$28.65	$28.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $89.72 / $89.72 / $89.72	Professional		$89.72	$89.72	$89.72
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 / $53.31 / $230.03	Professional		$42.13	$53.31	$230.03
United Facility/Professional Professional Modifier Low / Median / High Price $22.75 / $33.70 / $78.42	Professional		$22.75	$33.70	$78.42