Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.20 / $165.76 / $257.30	Facility		$89.20	$165.76	$257.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.46 / $77.80 / $168.74	Professional		$59.46	$77.80	$168.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.81 / $193.26 / $204.41	Facility		$159.81	$193.26	$204.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.92 / $74.33 / $319.62	Professional		$35.92	$74.33	$319.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.33 / $110.40 / $205.31	Facility		$74.33	$110.40	$205.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.33 / $78.05 / $96.20	Professional		$74.33	$78.05	$96.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.55 / $239.04 / $366.69	Facility		$204.55	$239.04	$366.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.49 / $200.16 / $227.45	Professional		$85.49	$200.16	$227.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.23 / $89.20 / $260.16	Facility		$57.23	$89.20	$260.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $89.20 / $260.16	Facility		$66.90	$89.20	$260.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.11 / $59.55 / $267.58	Professional		$43.11	$59.55	$267.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.23 / $89.20 / $260.16	Facility		$57.23	$89.20	$260.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $149.50 / $189.61 / $253.00	Professional		$149.50	$189.61	$253.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $194.25 / $353.07 / $353.07	Facility		$194.25	$353.07	$353.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.78 / $371.65 / $371.65	Professional		$107.78	$371.65	$371.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $74.84 / $158.29	Professional		$74.84	$74.84	$158.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $246.51 / $405.84	Professional		$74.84	$246.51	$405.84
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $59.46 / $208.43	Professional		$41.69	$59.46	$208.43