Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.22 / $81.81 / $96.38	Facility		$43.22	$81.81	$96.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.98 / $43.24 / $57.65	Professional		$41.98	$43.24	$57.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $77.66 / $93.62	Facility		$52.48	$77.66	$93.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.98 / $41.98 / $53.31	Professional		$41.98	$41.98	$53.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.47 / $57.47 / $67.17	Facility		$57.47	$57.47	$67.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.98 / $53.49 / $113.05	Facility		$41.98	$53.49	$113.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.04 / $62.34 / $70.84	Professional		$42.04	$62.34	$70.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.96 / $41.96 / $92.67	Facility		$41.96	$41.96	$92.67
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $62.94 / $83.96 / $83.96	Professional		$62.94	$83.96	$83.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.96 / $41.96 / $92.67	Facility		$41.96	$41.96	$92.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.96 / $41.96 / $83.96	Professional		$41.96	$41.96	$83.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $41.24 / $85.00	Professional		$41.24	$41.24	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $41.96 / $41.96 / $92.67	Facility		$41.96	$41.96	$92.67
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $62.94 / $83.96 / $83.96	Professional		$62.94	$83.96	$83.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.98 / $55.01 / $140.80	Professional		$41.98	$55.01	$140.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $41.98 / $41.98 / $206.20	Facility		$41.98	$41.98	$206.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.98 / $41.98 / $41.98	Professional		$41.98	$41.98	$41.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $58.94 / $58.94 / $58.94	Professional		$58.94	$58.94	$58.94
United Facility/Professional Professional Modifier Low / Median / High Price $41.98 / $41.98 / $54.57	Professional		$41.98	$41.98	$54.57