Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.95 / $100.25 / $118.08	Facility		$52.95	$100.25	$118.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $81.28 / $108.38	Professional		$78.92	$81.28	$108.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.65 / $146.00 / $175.99	Facility		$98.65	$146.00	$175.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $78.92 / $100.22	Professional		$78.92	$78.92	$100.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $116.80 / $126.27 / $144.65	Facility		$116.80	$126.27	$144.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.59 / $133.49 / $190.81	Facility		$73.59	$133.49	$190.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.96 / $93.26 / $105.98	Professional		$54.96	$93.26	$105.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.41 / $51.41 / $173.94	Facility		$51.41	$51.41	$173.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $77.12 / $157.84 / $157.84	Professional		$77.12	$157.84	$157.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.41 / $51.41 / $113.35	Facility		$51.41	$51.41	$113.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.41 / $57.23 / $157.84	Professional		$51.41	$57.23	$157.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $52.38 / $127.81	Professional		$50.00	$52.38	$127.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $51.41 / $51.41 / $173.94	Facility		$51.41	$51.41	$173.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $77.12 / $157.84 / $157.84	Professional		$77.12	$157.84	$157.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $88.42 / $196.46	Professional		$78.92	$88.42	$196.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $78.92 / $78.92 / $261.89	Facility		$78.92	$78.92	$261.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $78.92 / $78.92	Professional		$78.92	$78.92	$78.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $110.80 / $110.80 / $110.80	Professional		$110.80	$110.80	$110.80
United Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $87.85 / $116.10	Professional		$78.92	$87.85	$116.10