Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.63 / $78.73 / $92.75	Facility		$40.63	$78.73	$92.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $40.63 / $143.55	Professional		$39.45	$40.63	$143.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.31 / $49.31 / $49.31	Facility		$49.31	$49.31	$49.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $39.45 / $50.10	Professional		$39.45	$39.45	$50.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.01 / $54.01 / $63.12	Facility		$54.01	$54.01	$63.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.45 / $96.86 / $138.44	Facility		$39.45	$96.86	$138.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $189.26 / $215.06	Professional		$33.08	$189.26	$215.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.45 / $40.38 / $86.97	Facility		$39.45	$40.38	$86.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $60.57 / $78.90 / $104.48	Professional		$60.57	$78.90	$104.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.38 / $40.38 / $89.10	Facility		$40.38	$40.38	$89.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.38 / $40.38 / $78.90	Professional		$40.38	$40.38	$78.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $65.00 / $85.00	Professional		$32.47	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.45 / $40.38 / $86.97	Facility		$39.45	$40.38	$86.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $60.57 / $78.90 / $104.48	Professional		$60.57	$78.90	$104.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.44 / $66.51 / $187.00	Professional		$39.44	$66.51	$187.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $430.71 / $430.71 / $430.71	Facility		$430.71	$430.71	$430.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $39.45 / $39.45	Professional		$39.45	$39.45	$39.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.39 / $55.39 / $115.77	Professional		$55.39	$55.39	$115.77
United Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $39.45 / $63.12	Professional		$39.45	$39.45	$63.12