Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.97 / $3,476.87 / $11,160.65	Facility		$48.97	$3,476.87	$11,160.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $48.97 / $5,289.60	Professional		$47.55	$48.97	$5,289.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.97 / $102.23 / $106.04	Facility		$87.97	$102.23	$106.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $47.55 / $71.31	Professional		$47.55	$47.55	$71.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.28 / $64.28 / $87.16	Facility		$43.28	$64.28	$87.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.28 / $47.55 / $110.25	Professional		$43.28	$47.55	$110.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.56 / $56.97 / $71.20	Facility		$32.56	$56.97	$71.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.98 / $35.53 / $47.55	Professional		$20.98	$35.53	$47.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.28 / $48.02 / $68.56	Facility		$43.28	$48.02	$68.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.28 / $43.28 / $90.67	Facility		$43.28	$43.28	$90.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.28 / $48.18 / $160.44	Professional		$43.28	$48.18	$160.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.28 / $58.40 / $85.00	Professional		$43.28	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $43.28 / $47.55 / $68.56	Facility		$43.28	$47.55	$68.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $47.55 / $117.70	Professional		$44.39	$47.55	$117.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $47.55 / $92.49 / $393.60	Facility		$47.55	$92.49	$393.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $92.49 / $160.44	Professional		$47.55	$92.49	$160.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.76 / $66.76 / $134.83	Professional		$66.76	$66.76	$134.83
United Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $48.98 / $59.91	Professional		$47.55	$48.98	$59.91