Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.05 / $104.08 / $119.53	Facility		$54.05	$104.08	$119.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $53.00 / $62.97	Professional		$52.47	$53.00	$62.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.59 / $97.07 / $117.01	Facility		$65.59	$97.07	$117.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $52.47 / $70.83	Professional		$52.47	$52.47	$70.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.95 / $94.45 / $96.18	Facility		$83.95	$94.45	$96.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.47 / $76.18 / $139.37	Facility		$52.47	$76.18	$139.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $64.83 / $95.98	Professional		$52.47	$64.83	$95.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.12 / $52.47 / $57.72	Facility		$47.12	$52.47	$57.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $104.94 / $104.94	Professional		$78.06	$104.94	$104.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.12 / $52.04 / $57.54	Facility		$47.12	$52.04	$57.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $57.93 / $1,790.38	Professional		$52.04	$57.93	$1,790.38
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 $44.88 / $52.47 / $57.72	Facility		$44.88	$52.47	$57.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $104.94 / $104.94	Professional		$78.06	$104.94	$104.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $71.14 / $155.00	Professional		$52.47	$71.14	$155.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $52.47 / $85.00 / $254.60	Facility		$52.47	$85.00	$254.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $92.49 / $1,790.38	Professional		$52.47	$92.49	$1,790.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.80 / $73.67 / $73.67	Professional		$47.80	$73.67	$73.67
United Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $55.09 / $62.44	Professional		$52.47	$55.09	$62.44