Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.75 / $281.50 / $467.54	Facility		$140.75	$281.50	$467.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $140.75 / $368.79	Professional		$140.75	$140.75	$368.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $260.39 / $302.61 / $313.87	Facility		$260.39	$302.61	$313.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $147.37 / $210.90	Professional		$140.75	$147.37	$210.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $225.20 / $225.20 / $294.17	Facility		$225.20	$225.20	$294.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.82 / $341.67 / $488.40	Facility		$161.82	$341.67	$488.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.40 / $309.52 / $351.74	Professional		$143.40	$309.52	$351.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $123.92 / $140.75 / $235.05	Facility		$123.92	$140.75	$235.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $281.50 / $281.50 / $281.50	Professional		$281.50	$281.50	$281.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.50 / $140.75 / $235.05	Facility		$108.50	$140.75	$235.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.47 / $173.08 / $281.50	Professional		$144.47	$173.08	$281.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $343.43	Professional		$65.00	$85.00	$343.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $123.92 / $140.75 / $235.05	Facility		$123.92	$140.75	$235.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $281.50 / $281.50 / $281.50	Professional		$281.50	$281.50	$281.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $331.77 / $478.50	Professional		$140.75	$331.77	$478.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $624.29 / $624.29 / $624.29	Facility		$624.29	$624.29	$624.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $161.82 / $161.82 / $161.82	Professional		$161.82	$161.82	$161.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $174.01 / $197.61 / $220.17	Professional		$174.01	$197.61	$220.17
United Facility/Professional Professional Modifier Low / Median / High Price $144.47 / $163.26 / $236.95	Professional		$144.47	$163.26	$236.95