Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.67 / $143.11 / $168.57	Facility		$73.67	$143.11	$168.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $74.40 / $209.10	Professional		$71.52	$74.40	$209.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.40 / $89.40 / $89.40	Facility		$89.40	$89.40	$89.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $90.83	Professional		$71.52	$71.52	$90.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.92 / $97.92 / $114.43	Facility		$97.92	$97.92	$114.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $177.81 / $254.16	Facility		$71.52	$177.81	$254.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.34 / $113.99 / $129.54	Professional		$75.34	$113.99	$129.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $73.39 / $128.49	Facility		$71.52	$73.39	$128.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $71.62 / $143.04 / $143.04	Professional		$71.62	$143.04	$143.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.39 / $73.39 / $128.49	Facility		$73.39	$73.39	$128.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.39 / $73.39 / $143.04	Professional		$73.39	$73.39	$143.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $73.39 / $85.00	Professional		$65.00	$73.39	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $73.39 / $128.49	Facility		$71.52	$73.39	$128.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $71.62 / $143.04 / $143.04	Professional		$71.62	$143.04	$143.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $111.33 / $226.00	Professional		$71.52	$111.33	$226.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $407.85 / $407.85 / $407.85	Facility		$407.85	$407.85	$407.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $71.52	Professional		$71.52	$71.52	$71.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $99.89 / $100.41 / $126.39	Professional		$99.89	$100.41	$126.39
United Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $107.28	Professional		$71.52	$71.52	$107.28