Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.56 / $150.10 / $439.10	Facility		$66.56	$150.10	$439.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $66.56 / $201.35	Professional		$64.62	$66.56	$201.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.78 / $80.78 / $80.78	Facility		$80.78	$80.78	$80.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $64.62 / $82.06	Professional		$64.62	$64.62	$82.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.47 / $88.47 / $103.39	Facility		$88.47	$88.47	$103.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.62 / $158.69 / $226.83	Facility		$64.62	$158.69	$226.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $125.98 / $143.16	Professional		$64.62	$125.98	$143.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.62 / $75.05 / $142.57	Facility		$64.62	$75.05	$142.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4.80 / $129.24 / $129.24	Professional		$4.80	$129.24	$129.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.53 / $75.05 / $165.38	Facility		$72.53	$75.05	$165.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.05 / $75.05 / $129.24	Professional		$75.05	$75.05	$129.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.95 / $85.00	Professional		$65.00	$65.95	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.62 / $75.05 / $142.57	Facility		$64.62	$75.05	$142.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4.80 / $129.24 / $129.24	Professional		$4.80	$129.24	$129.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $98.13 / $192.00	Professional		$64.62	$98.13	$192.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $378.80 / $378.80 / $378.80	Facility		$378.80	$378.80	$378.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $64.62 / $64.62	Professional		$64.62	$64.62	$64.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $90.73 / $124.73	Professional		$90.73	$90.73	$124.73
United Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $64.62 / $103.39	Professional		$64.62	$64.62	$103.39