Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.69 / $142.11 / $211.27	Facility		$113.69	$142.11	$211.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.95 / $113.69 / $196.38	Professional		$72.95	$113.69	$196.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.69 / $246.32 / $260.54	Facility		$203.69	$246.32	$260.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.34 / $94.74 / $407.38	Professional		$45.34	$94.74	$407.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $249.30 / $249.30 / $259.11	Facility		$249.30	$249.30	$259.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $260.42 / $304.33 / $466.84	Facility		$260.42	$304.33	$466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.03 / $255.11 / $289.89	Professional		$109.03	$255.11	$289.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.95 / $113.69 / $331.59	Facility		$72.95	$113.69	$331.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.27 / $113.69 / $331.59	Facility		$85.27	$113.69	$331.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $75.15 / $341.06	Professional		$54.90	$75.15	$341.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $261.48	Professional		$50.00	$70.00	$261.48
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $72.95 / $113.69 / $331.59	Facility		$72.95	$113.69	$331.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.45 / $238.89 / $322.30	Professional		$190.45	$238.89	$322.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $245.15 / $450.02 / $450.02	Facility		$245.15	$450.02	$450.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $137.37 / $473.70 / $473.70	Professional		$137.37	$473.70	$473.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.46 / $94.46 / $201.75	Professional		$94.46	$94.46	$201.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.46 / $94.46 / $517.28	Professional		$94.46	$94.46	$517.28
United Facility/Professional Professional Modifier Low / Median / High Price $52.61 / $75.15 / $221.93	Professional		$52.61	$75.15	$221.93