Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.88 / $109.38 / $128.83	Facility		$51.88	$109.38	$128.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.37 / $51.88 / $126.07	Professional		$50.37	$51.88	$126.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.96 / $93.17 / $112.30	Facility		$62.96	$93.17	$112.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.37 / $50.37 / $63.96	Professional		$50.37	$50.37	$63.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.95 / $68.95 / $80.59	Facility		$68.95	$68.95	$80.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.37 / $146.36 / $209.21	Facility		$50.37	$146.36	$209.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.01 / $92.51 / $105.13	Professional		$61.01	$92.51	$105.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.45 / $50.37 / $56.09	Facility		$32.45	$50.37	$56.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $17.37 / $100.74 / $100.74	Professional		$17.37	$100.74	$100.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.45 / $56.09 / $56.09	Facility		$32.45	$56.09	$56.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.09 / $62.44 / $100.74	Professional		$56.09	$62.44	$100.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.88 / $65.00 / $85.00	Professional		$59.88	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $32.45 / $50.37 / $56.09	Facility		$32.45	$50.37	$56.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $17.37 / $100.74 / $100.74	Professional		$17.37	$100.74	$100.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.36 / $66.90 / $186.00	Professional		$50.36	$66.90	$186.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.37 / $50.37 / $299.39	Facility		$50.37	$50.37	$299.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.37 / $50.37 / $50.37	Professional		$50.37	$50.37	$50.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $70.72 / $73.41	Professional		$48.70	$70.72	$73.41
United Facility/Professional Professional Modifier Low / Median / High Price $50.37 / $56.07 / $75.03	Professional		$50.37	$56.07	$75.03