Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.92 / $191.92 / $191.92	Facility		$191.92	$191.92	$191.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.91 / $191.92 / $263.56	Professional		$191.91	$191.92	$263.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $355.05 / $412.63 / $427.98	Facility		$355.05	$412.63	$427.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.72 / $171.72 / $287.39	Professional		$171.72	$171.72	$287.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $307.07 / $307.07 / $401.11	Facility		$307.07	$307.07	$401.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $191.92 / $191.92 / $395.50	Facility		$191.92	$191.92	$395.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.92 / $231.13 / $315.95	Professional		$191.92	$231.13	$315.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $161.54 / $161.54 / $422.71	Facility		$161.54	$161.54	$422.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $153.04 / $161.54 / $355.70	Facility		$153.04	$161.54	$355.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $161.54 / $170.04 / $255.06	Professional		$161.54	$170.04	$255.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $161.54 / $394.16	Professional		$85.00	$161.54	$394.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $161.54 / $161.54 / $422.71	Facility		$161.54	$161.54	$422.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $191.92 / $380.59 / $548.90	Professional		$191.92	$380.59	$548.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $585.00 / $585.00 / $585.00	Facility		$585.00	$585.00	$585.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $188.55 / $188.55 / $188.55	Professional		$188.55	$188.55	$188.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $269.45 / $269.45 / $269.45	Professional		$269.45	$269.45	$269.45
United Facility/Professional Professional Modifier Low / Median / High Price $168.35 / $190.24 / $292.93	Professional		$168.35	$190.24	$292.93