Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.98 / $130.52 / $149.88	Facility		$67.98	$130.52	$149.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $66.66 / $90.63	Professional		$66.00	$66.66	$90.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.50 / $122.10 / $147.18	Facility		$82.50	$122.10	$147.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $66.00 / $89.10	Professional		$66.00	$66.00	$89.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $105.60 / $118.80 / $120.97	Facility		$105.60	$118.80	$120.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $98.52 / $180.22	Facility		$66.00	$98.52	$180.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $83.16 / $121.78	Professional		$66.00	$83.16	$121.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $59.95 / $66.00 / $72.59	Facility		$59.95	$66.00	$72.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $97.89 / $132.00 / $132.00	Professional		$97.89	$132.00	$132.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.95 / $65.26 / $72.16	Facility		$59.95	$65.26	$72.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.26 / $72.65 / $283.51	Professional		$65.26	$72.65	$283.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.28 / $85.00	Professional		$50.00	$65.28	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $55.90 / $66.00 / $72.59	Facility		$55.90	$66.00	$72.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $97.89 / $132.00 / $132.00	Professional		$97.89	$132.00	$132.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $84.54 / $199.00	Professional		$66.00	$84.54	$199.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $66.00 / $326.39	Facility		$66.00	$66.00	$326.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $118.13 / $283.51	Professional		$66.00	$118.13	$283.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $92.66 / $92.66	Professional		$57.06	$92.66	$92.66
United Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $69.30 / $83.15	Professional		$66.00	$69.30	$83.15