Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.13 / $147.93 / $174.25	Facility		$78.13	$147.93	$174.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $78.13 / $141.82	Professional		$75.86	$78.13	$141.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.83 / $140.34 / $169.17	Facility		$94.83	$140.34	$169.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $96.34	Professional		$75.86	$75.86	$96.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.86 / $103.86 / $121.38	Facility		$103.86	$103.86	$121.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $91.47 / $190.16	Facility		$75.86	$91.47	$190.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.61 / $100.38 / $114.06	Professional		$73.61	$100.38	$114.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.04 / $75.86 / $167.51	Facility		$45.04	$75.86	$167.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $113.79 / $151.72 / $151.72	Professional		$113.79	$151.72	$151.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.04 / $75.86 / $167.51	Facility		$45.04	$75.86	$167.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $151.72	Professional		$75.86	$75.86	$151.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $72.27 / $85.00	Professional		$65.00	$72.27	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.04 / $75.86 / $167.51	Facility		$45.04	$75.86	$167.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $113.79 / $151.72 / $151.72	Professional		$113.79	$151.72	$151.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $86.42 / $224.00	Professional		$75.86	$86.42	$224.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $361.35 / $361.35 / $361.35	Facility		$361.35	$361.35	$361.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.15 / $106.51 / $106.51	Professional		$61.15	$106.51	$106.51
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $106.20	Professional		$75.86	$75.86	$106.20