Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.66 / $195.99 / $261.32	Facility		$130.66	$195.99	$261.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $134.19 / $312.02	Professional		$134.19	$134.19	$312.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $248.25 / $288.51 / $299.24	Facility		$248.25	$288.51	$299.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $134.19 / $181.15	Professional		$134.19	$134.19	$181.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $214.70 / $214.70 / $280.45	Facility		$214.70	$214.70	$280.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.04 / $339.71 / $485.59	Facility		$177.04	$339.71	$485.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $303.24 / $344.59	Professional		$150.29	$303.24	$344.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.13 / $130.66 / $216.19	Facility		$120.13	$130.66	$216.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $268.38 / $268.38 / $268.38	Professional		$268.38	$268.38	$268.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.13 / $130.66 / $216.19	Facility		$120.13	$130.66	$216.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.66 / $156.79 / $268.38	Professional		$130.66	$156.79	$268.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $122.60 / $143.22	Professional		$65.00	$122.60	$143.22
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $120.13 / $130.66 / $216.19	Facility		$120.13	$130.66	$216.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $268.38 / $268.38 / $268.38	Professional		$268.38	$268.38	$268.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $208.89 / $452.00	Professional		$134.19	$208.89	$452.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $975.00 / $975.00 / $975.00	Facility		$975.00	$975.00	$975.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.04 / $177.04 / $177.04	Professional		$177.04	$177.04	$177.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $188.40 / $188.40 / $189.06	Professional		$188.40	$188.40	$189.06
United Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $151.63 / $233.49	Professional		$134.19	$151.63	$233.49