Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.28 / $28.28 / $28.28	Facility		$28.28	$28.28	$28.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $28.95 / $39.08	Professional		$28.28	$28.95	$39.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.13 / $85.46 / $194.65	Professional		$44.13	$85.46	$194.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.45 / $129.36 / $129.36	Facility		$60.45	$129.36	$129.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.85 / $140.05 / $186.14	Facility		$119.85	$140.05	$186.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $61.73 / $90.47	Professional		$30.86	$61.73	$90.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.28 / $39.08 / $101.82	Facility		$28.28	$39.08	$101.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $34.61 / $60.45	Professional		$34.61	$34.61	$60.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.28 / $39.08 / $101.82	Facility		$28.28	$39.08	$101.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $32.71 / $76.58	Professional		$28.10	$32.71	$76.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $64.32 / $85.00	Professional		$50.00	$64.32	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.28 / $39.08 / $101.82	Facility		$28.28	$39.08	$101.82
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $34.61 / $60.45	Professional		$34.61	$34.61	$60.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $117.81 / $153.57	Professional		$64.34	$117.81	$153.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $96.14 / $98.32 / $270.82	Facility		$96.14	$98.32	$270.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $219.33 / $282.11	Professional		$30.86	$219.33	$282.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.59 / $41.59 / $41.59	Professional		$41.59	$41.59	$41.59
United Facility/Professional Professional Modifier Low / Median / High Price $25.63 / $30.16 / $56.32	Professional		$25.63	$30.16	$56.32