Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.64 / $139.74 / $164.60	Facility		$68.64	$139.74	$164.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $68.64 / $166.11	Professional		$66.64	$68.64	$166.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.30 / $123.28 / $148.61	Facility		$83.30	$123.28	$148.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $84.63	Professional		$66.64	$66.64	$84.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.24 / $91.24 / $106.62	Facility		$91.24	$91.24	$106.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $166.64 / $238.20	Facility		$66.64	$166.64	$238.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $92.98 / $105.66	Professional		$66.64	$92.98	$105.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $59.28 / $66.64 / $71.66	Facility		$59.28	$66.64	$71.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $133.28 / $133.28	Professional		$41.69	$133.28	$133.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.28 / $71.66 / $71.66	Facility		$59.28	$71.66	$71.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.66 / $80.26 / $133.28	Professional		$71.66	$80.26	$133.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.15 / $85.00	Professional		$65.00	$65.15	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $59.28 / $66.64 / $71.66	Facility		$59.28	$66.64	$71.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $133.28 / $133.28	Professional		$41.69	$133.28	$133.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $100.98 / $204.00	Professional		$66.64	$100.98	$204.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $325.75 / $325.75 / $325.75	Facility		$325.75	$325.75	$325.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $66.64	Professional		$66.64	$66.64	$66.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.42 / $93.56 / $101.76	Professional		$80.42	$93.56	$101.76
United Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $74.64 / $99.96	Professional		$66.64	$74.64	$99.96