Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.15 / $112.73 / $150.30	Facility		$75.15	$112.73	$150.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.15 / $75.15 / $108.97	Professional		$75.15	$75.15	$108.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.01 / $161.55 / $167.56	Facility		$139.01	$161.55	$167.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.19 / $70.19 / $91.68	Professional		$70.19	$70.19	$91.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.24 / $120.24 / $157.06	Facility		$120.24	$120.24	$157.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.88 / $182.45 / $260.80	Facility		$80.88	$182.45	$260.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.58 / $165.24 / $187.78	Professional		$76.58	$165.24	$187.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $75.15 / $75.15	Facility		$25.13	$75.15	$75.15
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $150.30 / $150.30 / $150.30	Professional		$150.30	$150.30	$150.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $74.18 / $75.15	Facility		$25.13	$74.18	$75.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.81 / $82.42 / $150.30	Professional		$68.81	$82.42	$150.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $75.15 / $183.37	Professional		$15.00	$75.15	$183.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $75.15 / $75.15	Facility		$25.13	$75.15	$75.15
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $150.30 / $150.30 / $150.30	Professional		$150.30	$150.30	$150.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.15 / $176.95 / $255.20	Professional		$75.15	$176.95	$255.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $300.14 / $300.14 / $300.14	Facility		$300.14	$300.14	$300.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.88 / $80.88 / $80.88	Professional		$80.88	$80.88	$80.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $105.51 / $105.51	Professional		$27.77	$105.51	$105.51
United Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $81.59 / $115.54	Professional		$72.20	$81.59	$115.54