Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.12 / $26.12 / $26.12	Facility		$26.12	$26.12	$26.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.12 / $40.20 / $145.78	Professional		$26.12	$40.20	$145.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.77 / $51.77 / $85.42	Facility		$51.77	$51.77	$85.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.15 / $48.15 / $59.01	Professional		$48.15	$48.15	$59.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $110.79 / $110.79 / $110.79	Facility		$110.79	$110.79	$110.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.77 / $162.16 / $248.77	Facility		$138.77	$162.16	$248.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $86.23 / $97.99	Professional		$60.00	$86.23	$97.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.20 / $51.77 / $54.36	Facility		$40.20	$51.77	$54.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.20 / $51.77 / $54.36	Facility		$40.20	$51.77	$54.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.58 / $33.01 / $43.05	Professional		$24.58	$33.01	$43.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.01 / $65.00 / $85.00	Professional		$33.01	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.20 / $51.77 / $54.36	Facility		$40.20	$51.77	$54.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $77.66 / $138.51	Professional		$51.77	$77.66	$138.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $241.16 / $241.16 / $241.16	Facility		$241.16	$241.16	$241.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $34.94 / $34.94	Professional		$34.94	$34.94	$34.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $51.77 / $51.77	Professional		$51.77	$51.77	$51.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $51.77 / $51.77	Professional		$51.77	$51.77	$51.77
United Facility/Professional Professional Modifier Low / Median / High Price $18.07 / $25.83 / $43.47	Professional		$18.07	$25.83	$43.47