Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.79 / $73.92 / $84.90	Facility		$37.79	$73.92	$84.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $37.49 / $44.72	Professional		$36.69	$37.49	$44.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.86 / $67.88 / $81.81	Facility		$45.86	$67.88	$81.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $36.69 / $55.03	Professional		$36.69	$36.69	$55.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.70 / $66.04 / $67.25	Facility		$58.70	$66.04	$67.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.69 / $49.46 / $102.81	Facility		$36.69	$49.46	$102.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $43.27 / $73.45	Professional		$36.69	$43.27	$73.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.69 / $37.49 / $42.72	Facility		$36.69	$37.49	$42.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $73.38 / $73.38	Professional		$55.44	$73.38	$73.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.96 / $37.49 / $42.72	Facility		$36.96	$37.49	$42.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.96 / $41.14 / $167.55	Professional		$36.96	$41.14	$167.55
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 $36.69 / $37.49 / $42.72	Facility		$36.69	$37.49	$42.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $73.38 / $73.38	Professional		$55.44	$73.38	$73.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $48.57 / $124.30	Professional		$36.69	$48.57	$124.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $36.69 / $47.91 / $205.70	Facility		$36.69	$47.91	$205.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $67.29 / $167.55	Professional		$36.69	$67.29	$167.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.51 / $51.51 / $58.30	Professional		$51.51	$51.51	$58.30
United Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $37.79 / $46.42	Professional		$36.69	$37.79	$46.42