Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.64 / $175.79 / $962.80	Facility		$52.64	$175.79	$962.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.81 / $33.34 / $59.50	Professional		$22.81	$33.34	$59.50
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 $14.04 / $17.69 / $150.29	Professional		$14.04	$17.69	$150.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $42.11 / $89.13	Facility		$35.09	$42.11	$89.13
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 $29.85 / $42.11 / $166.68	Facility		$29.85	$42.11	$166.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $22.47 / $162.30	Professional		$17.55	$22.47	$162.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $65.00 / $85.00	Professional		$28.07	$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 $62.77 / $83.30 / $116.83	Professional		$62.77	$83.30	$116.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $82.39 / $166.68 / $166.68	Facility		$82.39	$166.68	$166.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.88 / $175.45 / $175.45	Professional		$50.88	$175.45	$175.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.09 / $74.73	Professional		$35.09	$35.09	$74.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.09 / $191.59	Professional		$35.09	$35.09	$191.59
United Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $35.09 / $35.09	Facility		$35.09	$35.09	$35.09
United Facility/Professional Professional Modifier Low / Median / High Price $15.25 / $21.05 / $65.31	Professional		$15.25	$21.05	$65.31