Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $92.28 / $105.75	Facility		$41.38	$92.28	$105.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.38 / $41.38 / $78.62	Professional		$41.38	$41.38	$78.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $16.55 / $177.25	Professional		$16.55	$16.55	$177.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $49.66 / $105.11	Facility		$41.38	$49.66	$105.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.38 / $43.45 / $53.54	Professional		$41.38	$43.45	$53.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.29 / $118.87 / $161.86	Facility		$90.29	$118.87	$161.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.24 / $111.43 / $126.63	Professional		$46.24	$111.43	$126.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $45.52 / $144.83	Facility		$41.38	$45.52	$144.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $49.66 / $144.83	Facility		$41.38	$49.66	$144.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.64 / $43.84 / $135.72	Professional		$26.64	$43.84	$135.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.38 / $58.40 / $85.00	Professional		$41.38	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $45.52 / $144.83	Facility		$41.38	$45.52	$144.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.39 / $98.73 / $138.47	Professional		$74.39	$98.73	$138.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $82.76 / $196.56 / $196.56	Facility		$82.76	$196.56	$196.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $165.52 / $206.07	Professional		$32.11	$165.52	$206.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $88.14 / $88.14 / $88.14	Professional		$88.14	$88.14	$88.14
Security Health Facility/Professional Facility Modifier Low / Median / High Price $49.66 / $49.66 / $49.66	Facility		$49.66	$49.66	$49.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.38 / $41.38 / $225.93	Professional		$41.38	$41.38	$225.93
United Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $41.90 / $84.76	Professional		$24.86	$41.90	$84.76