Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.49 / $84.42 / $99.44	Facility		$44.49	$84.42	$99.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $44.49 / $113.66	Professional		$43.19	$44.49	$113.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.99 / $79.90 / $96.31	Facility		$53.99	$79.90	$96.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $43.19 / $54.85	Professional		$43.19	$43.19	$54.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.13 / $59.13 / $69.09	Facility		$59.13	$59.13	$69.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.19 / $50.63 / $121.34	Facility		$43.19	$50.63	$121.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $68.65 / $78.01	Professional		$43.95	$68.65	$78.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.75 / $43.29 / $95.52	Facility		$38.75	$43.29	$95.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $64.94 / $86.38 / $86.38	Professional		$64.94	$86.38	$86.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.75 / $43.29 / $95.52	Facility		$38.75	$43.29	$95.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.29 / $43.29 / $86.38	Professional		$43.29	$43.29	$86.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.14 / $65.00 / $85.00	Professional		$43.14	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $38.75 / $43.29 / $95.52	Facility		$38.75	$43.29	$95.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $64.94 / $86.38 / $86.38	Professional		$64.94	$86.38	$86.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $66.87 / $134.00	Professional		$43.19	$66.87	$134.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $43.19 / $43.19 / $216.90	Facility		$43.19	$43.19	$216.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $43.19 / $43.19	Professional		$43.19	$43.19	$43.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.65 / $60.64 / $66.62	Professional		$52.65	$60.64	$66.62
United Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $43.19 / $56.15	Professional		$43.19	$43.19	$56.15