Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.96 / $126.78 / $29,192.23	Facility		$63.96	$126.78	$29,192.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $63.96 / $85.28	Professional		$62.10	$63.96	$85.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.63 / $114.89 / $138.47	Facility		$77.63	$114.89	$138.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $83.83	Professional		$62.10	$62.10	$83.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.36 / $111.78 / $113.83	Facility		$99.36	$111.78	$113.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $129.13 / $224.02	Facility		$62.10	$129.13	$224.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $79.09 / $118.83	Professional		$62.10	$79.09	$118.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $63.39 / $74.52	Facility		$62.10	$63.39	$74.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $124.20 / $124.20	Professional		$95.09	$124.20	$124.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.39 / $63.39 / $70.42	Facility		$63.39	$63.39	$70.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $70.56 / $282.02	Professional		$63.39	$70.56	$282.02
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 $62.10 / $63.39 / $74.52	Facility		$62.10	$63.39	$74.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $124.20 / $124.20	Professional		$95.09	$124.20	$124.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.09 / $96.66 / $212.88	Professional		$62.09	$96.66	$212.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $78.84 / $314.95	Facility		$62.10	$78.84	$314.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $117.51 / $282.02	Professional		$62.10	$117.51	$282.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.19 / $87.19 / $87.19	Professional		$87.19	$87.19	$87.19
United Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $65.20 / $78.56	Professional		$62.10	$65.20	$78.56