Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.67 / $63.34 / $163.82	Facility		$31.67	$63.34	$163.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.77 / $45.92 / $99.39	Professional		$30.77	$45.92	$99.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.59 / $68.09 / $70.62	Facility		$58.59	$68.09	$70.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.47 / $28.47 / $42.70	Professional		$28.47	$28.47	$42.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.67 / $66.19 / $66.19	Facility		$50.67	$66.19	$66.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.76 / $74.70 / $106.77	Facility		$32.76	$74.70	$106.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.76 / $67.67 / $76.90	Professional		$32.76	$67.67	$76.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $31.67 / $47.54	Facility		$25.13	$31.67	$47.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $63.34 / $63.34 / $63.34	Professional		$63.34	$63.34	$63.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.46 / $31.67 / $107.50	Facility		$31.46	$31.67	$107.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $34.29 / $63.34	Professional		$28.58	$34.29	$63.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.67 / $65.00 / $85.00	Professional		$31.67	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $31.67 / $47.54	Facility		$25.13	$31.67	$47.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $63.34 / $63.34 / $63.34	Professional		$63.34	$63.34	$63.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.67 / $72.45 / $104.50	Professional		$31.67	$72.45	$104.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $121.46 / $121.46 / $121.46	Facility		$121.46	$121.46	$121.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.76 / $32.76 / $32.76	Professional		$32.76	$32.76	$32.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $44.46 / $44.46	Professional		$33.92	$44.46	$44.46
United Facility/Professional Professional Modifier Low / Median / High Price $29.26 / $33.06 / $47.99	Professional		$29.26	$33.06	$47.99