Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.17 / $170.17 / $170.17	Facility		$170.17	$170.17	$170.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.21 / $145.86 / $194.48	Professional		$107.21	$145.86	$194.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $215.40 / $215.40 / $392.03	Facility		$215.40	$215.40	$392.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.50 / $200.32 / $254.17	Professional		$182.50	$200.32	$254.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.54 / $28.03 / $46.10	Facility		$21.54	$28.03	$46.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.56 / $25.85 / $34.50	Professional		$21.56	$25.85	$34.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.10 / $665.60 / $909.72	Facility		$147.10	$665.60	$909.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.38 / $125.04 / $318.75	Professional		$107.38	$125.04	$318.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.07 / $111.65 / $238.85	Facility		$32.07	$111.65	$238.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $25.43 / $58.02	Professional		$25.43	$25.43	$58.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.32 / $111.65 / $761.52	Facility		$36.32	$111.65	$761.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.78 / $17.80 / $51.50	Professional		$11.78	$17.80	$51.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.29 / $50.00 / $65.00	Professional		$0.29	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.61 / $111.87 / $239.40	Facility		$31.61	$111.87	$239.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $25.43 / $58.02	Professional		$25.43	$25.43	$58.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.05 / $48.12 / $65.98	Professional		$24.05	$48.12	$65.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $147.10 / $761.52	Facility		$65.00	$147.10	$761.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.38 / $125.04 / $147.10	Professional		$107.38	$125.04	$147.10
United Facility/Professional Professional Modifier Low / Median / High Price $11.78 / $16.69 / $81.62	Professional		$11.78	$16.69	$81.62