Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.60 / $124.50 / $185.09	Facility		$99.60	$124.50	$185.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.91 / $78.84 / $126.22	Professional		$63.91	$78.84	$126.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $178.45 / $215.80 / $228.25	Facility		$178.45	$215.80	$228.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.20 / $83.00 / $355.50	Professional		$33.20	$83.00	$355.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $202.85 / $202.85 / $210.82	Facility		$202.85	$202.85	$210.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $227.98 / $266.42 / $408.69	Facility		$227.98	$266.42	$408.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.40 / $223.50 / $253.98	Professional		$95.40	$223.50	$253.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.91 / $99.60 / $290.50	Facility		$63.91	$99.60	$290.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.70 / $99.60 / $290.50	Facility		$74.70	$99.60	$290.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $50.17 / $255.96	Professional		$38.36	$50.17	$255.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $229.08	Professional		$50.00	$70.00	$229.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $63.91 / $99.60 / $290.50	Facility		$63.91	$99.60	$290.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.80 / $202.72 / $278.02	Professional		$158.80	$202.72	$278.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $338.45 / $394.25 / $394.25	Facility		$338.45	$394.25	$394.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.35 / $415.00 / $415.00	Professional		$120.35	$415.00	$415.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.72 / $62.72 / $176.75	Professional		$62.72	$62.72	$176.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.72 / $62.72 / $453.18	Professional		$62.72	$62.72	$453.18
United Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $83.00 / $83.00	Facility		$83.00	$83.00	$83.00
United Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $49.80 / $169.13	Professional		$34.86	$49.80	$169.13