Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.81 / $73.81 / $73.81	Facility		$73.81	$73.81	$73.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $73.81 / $101.37	Professional		$73.81	$73.81	$101.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.57 / $158.71 / $164.62	Facility		$136.57	$158.71	$164.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.43 / $66.43 / $90.06	Professional		$66.43	$66.43	$90.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $118.11 / $118.11 / $154.28	Facility		$118.11	$118.11	$154.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.52 / $179.24 / $256.20	Facility		$72.52	$179.24	$256.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.19 / $130.81 / $175.25	Professional		$110.19	$130.81	$175.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $73.81 / $73.81 / $162.52	Facility		$73.81	$73.81	$162.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.81 / $73.81 / $162.52	Facility		$73.81	$73.81	$162.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $77.70 / $116.55	Professional		$73.81	$77.70	$116.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $85.00 / $180.12	Professional		$73.81	$85.00	$180.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $73.81 / $73.81 / $162.52	Facility		$73.81	$73.81	$162.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $173.90 / $250.80	Professional		$73.81	$173.90	$250.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $291.38 / $291.38 / $291.38	Facility		$291.38	$291.38	$291.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.52 / $72.52 / $72.52	Professional		$72.52	$72.52	$72.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $103.64 / $103.64 / $103.64	Professional		$103.64	$103.64	$103.64
United Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $77.70 / $127.35	Professional		$73.81	$77.70	$127.35