Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.44 / $120.56 / $179.23	Facility		$96.44	$120.56	$179.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.90 / $76.34 / $315.92	Professional		$65.90	$76.34	$315.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.80 / $208.96 / $221.02	Facility		$172.80	$208.96	$221.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.23 / $49.02 / $332.53	Professional		$13.23	$49.02	$332.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.61 / $218.26 / $226.85	Facility		$53.61	$218.26	$226.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $220.77 / $257.99 / $395.77	Facility		$220.77	$257.99	$395.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $216.43 / $245.94	Professional		$92.10	$216.43	$245.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.47 / $49.08 / $96.44	Facility		$43.47	$49.08	$96.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.47 / $65.90 / $381.76	Facility		$43.47	$65.90	$381.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.14 / $80.37 / $222.62	Professional		$47.14	$80.37	$222.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.78 / $68.52 / $221.82	Professional		$39.78	$68.52	$221.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $43.47 / $49.08 / $96.44	Facility		$43.47	$49.08	$96.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $98.24 / $190.96 / $268.29	Professional		$98.24	$190.96	$268.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $160.74 / $160.74 / $381.76	Facility		$160.74	$160.74	$381.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.60 / $51.93 / $108.99	Professional		$42.60	$51.93	$108.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.66 / $82.66 / $171.15	Professional		$82.66	$82.66	$171.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.66 / $233.57 / $438.82	Professional		$82.66	$233.57	$438.82
United Facility/Professional Professional Modifier Low / Median / High Price $40.19 / $66.28 / $220.25	Professional		$40.19	$66.28	$220.25