Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.77 / $74.09 / $417.46	Facility		$37.77	$74.09	$417.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $37.77 / $44.38	Professional		$36.67	$37.77	$44.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.84 / $45.84 / $45.84	Facility		$45.84	$45.84	$45.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $36.67 / $49.50	Professional		$36.67	$36.67	$49.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.67 / $66.01 / $67.20	Facility		$58.67	$66.01	$67.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $62.51 / $129.94	Facility		$36.67	$62.51	$129.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $55.41 / $84.29	Professional		$36.67	$55.41	$84.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $37.04 / $75.89	Facility		$36.67	$37.04	$75.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $55.58 / $73.34 / $203.89	Professional		$55.58	$73.34	$203.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.04 / $37.04 / $75.89	Facility		$37.04	$37.04	$75.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $41.24 / $1,379.87	Professional		$37.04	$41.24	$1,379.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $37.04 / $80.56	Facility		$36.67	$37.04	$80.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $55.58 / $73.34 / $203.89	Professional		$55.58	$73.34	$203.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $57.07 / $145.00	Professional		$36.67	$57.07	$145.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $36.67 / $875.51	Facility		$36.67	$36.67	$875.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $86.09 / $1,379.87	Professional		$36.67	$86.09	$1,379.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $51.48 / $60.87	Professional		$41.00	$51.48	$60.87
United Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $38.50 / $46.39	Professional		$36.67	$38.50	$46.39