Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.07 / $77.77 / $91.61	Facility		$41.07	$77.77	$91.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $41.07 / $86.72	Professional		$39.86	$41.07	$86.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.84 / $73.76 / $88.91	Facility		$49.84	$73.76	$88.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $39.86 / $50.63	Professional		$39.86	$39.86	$50.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.58 / $54.58 / $63.79	Facility		$54.58	$54.58	$63.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.86 / $46.70 / $107.62	Facility		$39.86	$46.70	$107.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $49.17 / $66.34	Professional		$39.86	$49.17	$66.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.25 / $39.86 / $39.88	Facility		$26.25	$39.86	$39.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $79.73 / $79.73	Professional		$16.82	$79.73	$79.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.25 / $39.88 / $39.88	Facility		$26.25	$39.88	$39.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.88 / $39.88 / $79.73	Professional		$39.88	$39.88	$79.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $65.00 / $85.00	Professional		$38.61	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.25 / $39.86 / $39.88	Facility		$26.25	$39.86	$39.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $79.73 / $79.73	Professional		$16.82	$79.73	$79.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $54.11 / $119.00	Professional		$39.86	$54.11	$119.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $39.86 / $39.86 / $193.05	Facility		$39.86	$39.86	$193.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $39.86 / $39.86	Professional		$39.86	$39.86	$39.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $39.02 / $55.98 / $57.43	Professional		$39.02	$55.98	$57.43
United Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $39.86 / $51.83	Professional		$39.86	$39.86	$51.83