Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.41 / $276.60 / $704.20	Facility		$51.41	$276.60	$704.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.99 / $49.54 / $265.20	Professional		$32.99	$49.54	$265.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.11 / $111.38 / $117.81	Facility		$92.11	$111.38	$117.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.15 / $42.84 / $184.21	Professional		$21.15	$42.84	$184.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $63.63 / $120.90	Facility		$42.84	$63.63	$120.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $44.98 / $55.22	Professional		$42.84	$44.98	$55.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.05 / $137.94 / $211.61	Facility		$118.05	$137.94	$211.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.15 / $115.36 / $131.09	Professional		$49.15	$115.36	$131.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.56 / $54.84 / $149.94	Facility		$38.56	$54.84	$149.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $74.97 / $323.22	Facility		$42.84	$74.97	$323.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.62 / $36.40 / $635.00	Professional		$25.62	$36.40	$635.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $70.00 / $118.24	Professional		$42.84	$70.00	$118.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $38.56 / $54.84 / $149.94	Facility		$38.56	$54.84	$149.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $111.42 / $181.23	Professional		$85.80	$111.42	$181.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $125.19 / $211.27 / $211.27	Facility		$125.19	$211.27	$211.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.14 / $227.89 / $635.00	Professional		$55.14	$227.89	$635.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.23 / $91.23 / $154.60	Professional		$91.23	$91.23	$154.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $154.60 / $154.60 / $233.91	Professional		$154.60	$154.60	$233.91
United Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $34.27 / $117.40	Professional		$24.85	$34.27	$117.40