Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.83 / $149.83 / $229.84	Facility		$149.83	$149.83	$229.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.83 / $158.44 / $217.25	Professional		$149.83	$158.44	$217.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.96 / $149.96 / $176.27	Professional		$149.96	$149.96	$176.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $124.86 / $124.86 / $124.86	Facility		$124.86	$124.86	$124.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.66 / $330.60 / $472.56	Facility		$164.66	$330.60	$472.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.89 / $136.24 / $173.44	Professional		$119.89	$136.24	$173.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $71.69 / $137.58 / $176.27	Facility		$71.69	$137.58	$176.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.69 / $137.58 / $176.27	Facility		$71.69	$137.58	$176.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.02 / $166.13 / $235.23	Professional		$147.02	$166.13	$235.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $65.00 / $408.88	Professional		$15.00	$65.00	$408.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $71.69 / $137.58 / $176.27	Facility		$71.69	$137.58	$176.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.85 / $148.86 / $212.30	Professional		$100.85	$148.86	$212.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $623.78 / $623.78 / $623.78	Facility		$623.78	$623.78	$623.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.66 / $164.66 / $164.66	Professional		$164.66	$164.66	$164.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $151.32 / $151.32 / $151.32	Professional		$151.32	$151.32	$151.32
United Facility/Professional Professional Modifier Low / Median / High Price $147.02 / $166.13 / $235.23	Professional		$147.02	$166.13	$235.23