Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.37 / $57.04 / $65.50	Facility		$29.37	$57.04	$65.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $29.37 / $33.08	Professional		$28.52	$29.37	$33.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.65 / $52.76 / $63.60	Facility		$35.65	$52.76	$63.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $38.50	Professional		$28.52	$28.52	$38.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.63 / $51.34 / $52.28	Facility		$45.63	$51.34	$52.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.76 / $28.52 / $40.86	Facility		$15.76	$28.52	$40.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $32.61	Professional		$28.52	$28.52	$32.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.52 / $29.09 / $32.79	Facility		$28.52	$29.09	$32.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $57.04 / $57.04	Professional		$42.78	$57.04	$57.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.52 / $28.52 / $32.61	Facility		$28.52	$28.52	$32.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $31.75 / $145.84	Professional		$28.52	$31.75	$145.84
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 $28.52 / $28.80 / $32.79	Facility		$28.52	$28.80	$32.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $57.04 / $57.04	Professional		$42.78	$57.04	$57.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.51 / $28.52 / $44.39	Professional		$28.51	$28.52	$44.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $28.52 / $32.61 / $143.93	Facility		$28.52	$32.61	$143.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $40.68 / $145.84	Professional		$28.52	$40.68	$145.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $40.04 / $40.04 / $40.04	Professional		$40.04	$40.04	$40.04
United Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $30.23 / $36.08	Professional		$28.52	$30.23	$36.08