Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $52.64 / $78.25	Facility		$42.11	$52.64	$78.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $40.99 / $48.18	Professional		$28.07	$40.99	$48.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.44 / $91.23 / $96.50	Facility		$75.44	$91.23	$96.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.32 / $35.09 / $150.88	Professional		$17.32	$35.09	$150.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $52.12 / $99.03	Facility		$35.09	$52.12	$99.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $36.84 / $45.17	Professional		$35.09	$36.84	$45.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $112.67 / $172.85	Facility		$96.42	$112.67	$172.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.06 / $94.49 / $107.38	Professional		$40.06	$94.49	$107.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.02 / $42.11 / $122.82	Facility		$27.02	$42.11	$122.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.58 / $42.11 / $122.82	Facility		$31.58	$42.11	$122.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.60 / $29.42 / $133.62	Professional		$20.60	$29.42	$133.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $65.00 / $85.00	Professional		$35.09	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.02 / $42.11 / $122.82	Facility		$27.02	$42.11	$122.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $91.16 / $118.80	Professional		$70.20	$91.16	$118.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.18 / $167.46 / $167.46	Facility		$70.18	$167.46	$167.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.18 / $175.45 / $384.23	Professional		$45.18	$175.45	$384.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $36.11 / $74.73	Professional		$36.11	$36.11	$74.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $139.91 / $191.59	Professional		$36.11	$139.91	$191.59
United Facility/Professional Facility Modifier Low / Median / High Price $31.19 / $31.19 / $84.61	Facility		$31.19	$31.19	$84.61
United Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $28.07 / $96.16	Professional		$20.35	$28.07	$96.16