Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.00 / $613.70 / $978.85	Facility		$192.00	$613.70	$978.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $77.06 / $320.48	Professional		$40.65	$77.06	$320.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $63.00	Professional		$40.65	$40.65	$63.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.20 / $55.66 / $100.00	Facility		$41.20	$55.66	$100.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $54.88	Professional		$40.65	$40.65	$54.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $62.24 / $113.87	Facility		$40.65	$62.24	$113.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $112.11 / $127.40	Professional		$40.65	$112.11	$127.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $41.87 / $85.33	Facility		$40.65	$41.87	$85.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $43.82 / $43.82	Professional		$43.82	$43.82	$43.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.20 / $63.66 / $192.85	Facility		$41.20	$63.66	$192.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $41.20 / $1,627.92	Professional		$41.20	$41.20	$1,627.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $58.40 / $85.00	Professional		$40.65	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $41.87 / $85.33	Facility		$40.65	$41.87	$85.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $43.82 / $43.82	Professional		$43.82	$43.82	$43.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $50.59 / $144.65	Professional		$40.65	$50.59	$144.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $163.92 / $163.92 / $192.85	Facility		$163.92	$163.92	$192.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $163.92 / $1,627.92	Professional		$40.65	$163.92	$1,627.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.78 / $57.07 / $77.02	Professional		$54.78	$57.07	$77.02
United Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $57.82	Professional		$40.65	$40.65	$57.82