Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.02 / $77.67 / $91.47	Facility		$41.02	$77.67	$91.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $41.02 / $103.88	Professional		$39.83	$41.02	$103.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.79 / $73.67 / $88.80	Facility		$49.79	$73.67	$88.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $50.58	Professional		$39.83	$39.83	$50.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.53 / $54.53 / $63.73	Facility		$54.53	$54.53	$63.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.83 / $96.77 / $138.32	Facility		$39.83	$96.77	$138.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.61 / $62.16 / $70.64	Professional		$40.61	$62.16	$70.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.76 / $39.83 / $87.68	Facility		$36.76	$39.83	$87.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $59.75 / $79.66 / $79.66	Professional		$59.75	$79.66	$79.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.76 / $39.83 / $87.68	Facility		$36.76	$39.83	$87.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $79.66	Professional		$39.83	$39.83	$79.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $55.00 / $85.00	Professional		$39.86	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.76 / $39.83 / $87.68	Facility		$36.76	$39.83	$87.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $59.75 / $79.66 / $79.66	Professional		$59.75	$79.66	$79.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.82 / $52.87 / $135.30	Professional		$39.82	$52.87	$135.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $199.35 / $199.35 / $199.35	Facility		$199.35	$199.35	$199.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $39.83	Professional		$39.83	$39.83	$39.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $55.92 / $59.01	Professional		$50.12	$55.92	$59.01
United Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $51.78	Professional		$39.83	$39.83	$51.78