Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.12 / $26.54 / $129.94	Professional		$18.12	$26.54	$129.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.25 / $70.81 / $164.07	Professional		$13.25	$70.81	$164.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.38 / $23.38 / $33.33	Facility		$23.38	$23.38	$33.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $23.38 / $33.33	Professional		$22.50	$23.38	$33.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.81 / $86.16 / $122.29	Facility		$75.81	$86.16	$122.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.69 / $37.86 / $76.88	Professional		$11.69	$37.86	$76.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.72 / $28.06 / $72.75	Facility		$19.72	$28.06	$72.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.72 / $31.56 / $99.23	Facility		$19.72	$31.56	$99.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.38 / $68.47 / $143.78	Professional		$23.38	$68.47	$143.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.69 / $65.00 / $85.00	Professional		$11.69	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.72 / $28.06 / $72.75	Facility		$19.72	$28.06	$72.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $59.16 / $94.66	Professional		$45.00	$59.16	$94.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $113.59	Facility		$47.86	$47.86	$113.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.65 / $134.30 / $143.78	Professional		$11.65	$134.30	$143.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $65.34 / $124.05	Professional		$12.32	$65.34	$124.05
United Facility/Professional Professional Modifier Low / Median / High Price $19.87 / $27.97 / $72.72	Professional		$19.87	$27.97	$72.72