Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.06 / $100.90 / $115.87	Facility		$54.06	$100.90	$115.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $54.06 / $65.61	Professional		$52.49	$54.06	$65.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.61 / $97.11 / $117.05	Facility		$65.61	$97.11	$117.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $52.49 / $70.86	Professional		$52.49	$52.49	$70.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.98 / $94.48 / $96.21	Facility		$83.98	$94.48	$96.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.49 / $96.45 / $167.31	Facility		$52.49	$96.45	$167.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.91 / $58.24 / $83.39	Professional		$50.91	$58.24	$83.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.45 / $52.49 / $58.04	Facility		$50.45	$52.49	$58.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $75.68 / $104.98 / $104.98	Professional		$75.68	$104.98	$104.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.45 / $50.45 / $55.78	Facility		$50.45	$50.45	$55.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.45 / $56.16 / $218.09	Professional		$50.45	$56.16	$218.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $118.41	Professional		$50.00	$70.00	$118.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $50.45 / $52.49 / $58.42	Facility		$50.45	$52.49	$58.42
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $75.68 / $104.98 / $104.98	Professional		$75.68	$104.98	$104.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $75.22 / $165.33	Professional		$52.49	$75.22	$165.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $52.49 / $52.96 / $242.65	Facility		$52.49	$52.96	$242.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $90.87 / $218.09	Professional		$52.49	$90.87	$218.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $73.70 / $73.70	Professional		$73.70	$73.70	$73.70
United Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $54.07 / $64.17	Professional		$52.49	$54.07	$64.17