Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.03 / $96.29 / $143.13	Facility		$77.03	$96.29	$143.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $60.98 / $116.69	Professional		$52.64	$60.98	$116.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.01 / $166.89 / $176.52	Facility		$138.01	$166.89	$176.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.68 / $25.68 / $256.76	Professional		$25.68	$25.68	$256.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.26 / $156.88 / $163.04	Facility		$45.26	$156.88	$163.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.62 / $206.39 / $316.61	Facility		$176.62	$206.39	$316.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.51 / $172.85 / $196.43	Professional		$73.51	$172.85	$196.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.10 / $32.10 / $77.03	Facility		$32.10	$32.10	$77.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.10 / $52.64 / $304.89	Facility		$32.10	$52.64	$304.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $40.79 / $115.54	Professional		$24.48	$40.79	$115.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $64.19 / $177.16	Professional		$32.10	$64.19	$177.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $32.10 / $32.10 / $77.03	Facility		$32.10	$32.10	$77.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.23 / $152.72 / $214.20	Professional		$75.23	$152.72	$214.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $128.38 / $128.38 / $304.89	Facility		$128.38	$128.38	$304.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.60 / $34.02 / $34.02	Professional		$19.60	$34.02	$34.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $30.53 / $136.69	Professional		$30.53	$30.53	$136.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $30.53 / $350.48	Professional		$30.53	$30.53	$350.48
United Facility/Professional Facility Modifier Low / Median / High Price $77.03 / $77.03 / $77.03	Facility		$77.03	$77.03	$77.03
United Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $40.79 / $115.54	Professional		$24.48	$40.79	$115.54