Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.45 / $131.04 / $154.36	Facility		$51.45	$131.04	$154.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $51.45 / $134.16	Professional		$49.95	$51.45	$134.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.44 / $62.44 / $62.44	Facility		$62.44	$62.44	$62.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $67.20	Professional		$49.95	$49.95	$67.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.39 / $68.39 / $79.92	Facility		$68.39	$68.39	$79.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.95 / $94.44 / $135.00	Facility		$49.95	$94.44	$135.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.83 / $58.39 / $68.53	Professional		$54.83	$58.39	$68.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $67.20 / $109.78	Facility		$40.74	$67.20	$109.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $49.70 / $99.90 / $100.80	Professional		$49.70	$99.90	$100.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $67.20 / $148.26	Facility		$40.74	$67.20	$148.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $67.20 / $99.90	Professional		$67.20	$67.20	$99.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.82 / $65.00 / $85.00	Professional		$53.82	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $67.20 / $109.78	Facility		$40.74	$67.20	$109.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $49.70 / $99.90 / $100.80	Professional		$49.70	$99.90	$100.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $64.40 / $136.16	Professional		$49.95	$64.40	$136.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $273.30 / $273.30 / $273.30	Facility		$273.30	$273.30	$273.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $49.95	Professional		$49.95	$49.95	$49.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $70.13 / $83.32	Professional		$55.44	$70.13	$83.32
United Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $69.12	Professional		$49.95	$49.95	$69.12