Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.70 / $39.70 / $39.70	Facility		$39.70	$39.70	$39.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $39.70 / $42.40	Professional		$38.54	$39.70	$42.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $38.54 / $61.66	Professional		$38.54	$38.54	$61.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.77 / $61.66 / $94.81	Facility		$52.77	$61.66	$94.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.75 / $114.80 / $162.72	Facility		$62.75	$114.80	$162.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $64.27 / $134.05	Professional		$38.54	$64.27	$134.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $35.11 / $39.70 / $59.15	Facility		$35.11	$39.70	$59.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.11 / $49.61 / $75.89	Facility		$35.11	$49.61	$75.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.12 / $49.12 / $103.15	Professional		$49.12	$49.12	$103.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $123.17	Professional		$50.00	$70.00	$123.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $35.11 / $39.70 / $59.15	Facility		$35.11	$39.70	$59.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $41.81 / $110.09	Professional		$38.54	$41.81	$110.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $85.00 / $197.96	Facility		$65.00	$85.00	$197.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $64.16 / $197.96	Professional		$38.54	$64.16	$197.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $54.11 / $92.72	Professional		$54.11	$54.11	$92.72
United Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $38.54 / $50.10	Professional		$38.54	$38.54	$50.10