Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.80 / $198.80 / $198.80	Facility		$198.80	$198.80	$198.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.01 / $179.17 / $219.60	Professional		$117.01	$179.17	$219.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $260.89 / $286.99 / $474.84	Facility		$260.89	$286.99	$474.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.57 / $242.64 / $346.32	Professional		$194.57	$242.64	$346.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.39 / $55.83 / $55.83	Facility		$18.39	$55.83	$55.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.86 / $178.86 / $1,091.66	Facility		$178.86	$178.86	$1,091.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.03 / $303.75 / $379.69	Professional		$152.03	$303.75	$379.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.64 / $132.97 / $298.20	Facility		$23.64	$132.97	$298.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $31.31 / $187.86 / $187.86	Professional		$31.31	$187.86	$187.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.09 / $270.04 / $1,242.55	Facility		$26.09	$270.04	$1,242.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.80 / $148.22 / $255.57	Professional		$104.80	$148.22	$255.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.45 / $58.40 / $183.43	Professional		$0.45	$58.40	$183.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.64 / $198.80 / $298.20	Facility		$23.64	$198.80	$298.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $31.31 / $187.86 / $187.86	Professional		$31.31	$187.86	$187.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $55.22 / $71.69	Professional		$29.13	$55.22	$71.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $178.86 / $447.26 / $1,242.55	Facility		$178.86	$447.26	$1,242.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $178.86 / $178.86	Professional		$20.14	$178.86	$178.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $351.09 / $413.05 / $413.05	Professional		$351.09	$413.05	$413.05
United Facility/Professional Professional Modifier Low / Median / High Price $102.29 / $139.74 / $273.32	Professional		$102.29	$139.74	$273.32