Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.42 / $246.63 / $368.09	Facility		$164.42	$246.63	$368.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $164.42 / $368.79	Professional		$164.42	$164.42	$368.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $304.18 / $353.50 / $366.66	Facility		$304.18	$353.50	$366.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.86 / $190.53 / $234.28	Professional		$180.86	$190.53	$234.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $263.07 / $263.07 / $343.64	Facility		$263.07	$263.07	$343.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.66 / $383.94 / $548.80	Facility		$211.66	$383.94	$548.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.54 / $334.53 / $380.15	Professional		$172.54	$334.53	$380.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $123.92 / $164.42 / $235.05	Facility		$123.92	$164.42	$235.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $328.84 / $328.84 / $328.84	Professional		$328.84	$328.84	$328.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.92 / $164.42 / $242.25	Facility		$123.92	$164.42	$242.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $197.30 / $328.84	Professional		$164.42	$197.30	$328.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $401.18	Professional		$65.00	$85.00	$401.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $123.92 / $164.42 / $235.05	Facility		$123.92	$164.42	$235.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $328.84 / $328.84 / $328.84	Professional		$328.84	$328.84	$328.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $372.96 / $537.90	Professional		$164.42	$372.96	$537.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $815.59 / $815.59 / $815.59	Facility		$815.59	$815.59	$815.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $219.62 / $219.62 / $219.62	Professional		$219.62	$219.62	$219.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $164.27 / $230.85 / $230.85	Professional		$164.27	$230.85	$230.85
United Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $185.79 / $269.64	Professional		$164.42	$185.79	$269.64