Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.57 / $76.97 / $114.42	Facility		$61.57	$76.97	$114.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.51 / $61.57 / $201.74	Professional		$39.51	$61.57	$201.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.32 / $133.41 / $141.10	Facility		$110.32	$133.41	$141.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.34 / $51.31 / $220.63	Professional		$25.34	$51.31	$220.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $139.35 / $139.35 / $144.83	Facility		$139.35	$139.35	$144.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.47 / $165.33 / $253.61	Facility		$141.47	$165.33	$253.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.06 / $138.16 / $157.01	Professional		$59.06	$138.16	$157.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.51 / $61.57 / $179.59	Facility		$39.51	$61.57	$179.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.18 / $61.57 / $179.59	Facility		$46.18	$61.57	$179.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.33 / $43.33 / $184.72	Professional		$30.33	$43.33	$184.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $100.60	Professional		$50.00	$65.00	$100.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.51 / $61.57 / $179.59	Facility		$39.51	$61.57	$179.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.35 / $134.21 / $174.90	Professional		$103.35	$134.21	$174.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $110.11 / $243.72 / $243.72	Facility		$110.11	$243.72	$243.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.75 / $256.55 / $285.62	Professional		$70.75	$256.55	$285.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.79 / $52.79 / $109.27	Professional		$52.79	$52.79	$109.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.79 / $52.79 / $280.14	Professional		$52.79	$52.79	$280.14
United Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $51.31 / $51.31	Facility		$51.31	$51.31	$51.31
United Facility/Professional Professional Modifier Low / Median / High Price $23.09 / $41.05 / $142.13	Professional		$23.09	$41.05	$142.13