Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.09 / $200.60 / $30,205.41	Facility		$103.09	$200.60	$30,205.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $101.09 / $120.10	Professional		$100.09	$101.09	$120.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.11 / $185.17 / $223.20	Facility		$125.11	$185.17	$223.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $135.12	Professional		$100.09	$100.09	$135.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $160.13 / $180.16 / $183.45	Facility		$160.13	$180.16	$183.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $127.38 / $264.81	Facility		$100.09	$127.38	$264.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $119.91 / $181.36	Professional		$100.09	$119.91	$181.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $100.30 / $110.10	Facility		$89.18	$100.30	$110.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $150.44 / $200.18 / $200.18	Professional		$150.44	$200.18	$200.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $100.30 / $110.91	Facility		$89.18	$100.30	$110.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.30 / $111.65 / $428.03	Professional		$100.30	$111.65	$428.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $100.30 / $110.10	Facility		$89.18	$100.30	$110.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $150.44 / $200.18 / $200.18	Professional		$150.44	$200.18	$200.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $150.56 / $300.00	Professional		$100.09	$150.56	$300.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $102.69 / $485.70	Facility		$100.09	$102.69	$485.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $178.35 / $428.03	Professional		$100.09	$178.35	$428.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $140.53 / $144.16	Professional		$102.26	$140.53	$144.16
United Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $105.09 / $125.64	Professional		$100.09	$105.09	$125.64