Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.47 / $60.06 / $70.76	Facility		$29.47	$60.06	$70.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $29.47 / $133.62	Professional		$28.61	$29.47	$133.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.76 / $52.93 / $63.80	Facility		$35.76	$52.93	$63.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $28.61 / $36.33	Professional		$28.61	$28.61	$36.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.17 / $39.17 / $45.78	Facility		$39.17	$39.17	$45.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.61 / $65.84 / $94.13	Facility		$28.61	$65.84	$94.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.33 / $39.93 / $45.38	Professional		$23.33	$39.93	$45.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.61 / $30.80 / $158.01	Facility		$28.61	$30.80	$158.01
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $46.20 / $57.22 / $97.54	Professional		$46.20	$57.22	$97.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.80 / $30.80 / $158.01	Facility		$30.80	$30.80	$158.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.80 / $30.80 / $57.22	Professional		$30.80	$30.80	$57.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $65.00 / $85.00	Professional		$22.22	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.61 / $30.80 / $158.01	Facility		$28.61	$30.80	$158.01
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $46.20 / $57.22 / $97.54	Professional		$46.20	$57.22	$97.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $34.44 / $85.80	Professional		$28.61	$34.44	$85.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $28.61 / $28.61 / $255.00	Facility		$28.61	$28.61	$255.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $28.61 / $28.61	Professional		$28.61	$28.61	$28.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.17 / $40.17 / $87.69	Professional		$40.17	$40.17	$87.69
United Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $28.61 / $40.04	Professional		$28.61	$28.61	$40.04