Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.28 / $125.94 / $144.63	Facility		$63.28	$125.94	$144.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $63.28 / $84.37	Professional		$61.44	$63.28	$84.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.80 / $113.66 / $137.01	Facility		$76.80	$113.66	$137.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $61.44 / $82.94	Professional		$61.44	$61.44	$82.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.30 / $110.59 / $112.62	Facility		$98.30	$110.59	$112.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $85.36 / $177.46	Facility		$61.44	$85.36	$177.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $77.80 / $129.63	Professional		$61.44	$77.80	$129.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $62.97 / $76.80	Facility		$61.44	$62.97	$76.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $94.46 / $122.88 / $122.88	Professional		$94.46	$122.88	$122.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.97 / $62.97 / $70.09	Facility		$62.97	$62.97	$70.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.97 / $70.09 / $303.45	Professional		$62.97	$70.09	$303.45
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 $61.44 / $62.97 / $73.72	Facility		$61.44	$62.97	$73.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $94.46 / $122.88 / $122.88	Professional		$94.46	$122.88	$122.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $83.81 / $214.50	Professional		$61.44	$83.81	$214.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $79.48 / $375.40	Facility		$61.44	$79.48	$375.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $116.01 / $303.45	Professional		$61.44	$116.01	$303.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $86.26 / $86.26 / $86.26	Professional		$86.26	$86.26	$86.26
United Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $61.44 / $77.41	Professional		$61.44	$61.44	$77.41