Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $174.86 / $358.28	Facility		$42.11	$174.86	$358.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.81 / $40.99 / $80.16	Professional		$22.81	$40.99	$80.16
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 $31.58 / $44.92 / $122.82	Facility		$31.58	$44.92	$122.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.58 / $44.92 / $132.30	Facility		$31.58	$44.92	$132.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.60 / $29.63 / $325.62	Professional		$20.60	$29.63	$325.62
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 $31.58 / $44.92 / $122.82	Facility		$31.58	$44.92	$122.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $91.16 / $149.22	Professional		$70.20	$91.16	$149.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.33 / $227.00 / $227.00	Facility		$75.33	$227.00	$227.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.18 / $186.71 / $325.62	Professional		$45.18	$186.71	$325.62
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 / $101.98 / $191.59	Professional		$36.11	$101.98	$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 $18.43 / $28.07 / $86.89	Professional		$18.43	$28.07	$86.89