Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.81 / $166.81 / $166.81	Facility		$166.81	$166.81	$166.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.30 / $148.74 / $170.91	Professional		$101.30	$148.74	$170.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $250.40 / $455.73 / $455.73	Facility		$250.40	$455.73	$455.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.56 / $232.87 / $307.99	Professional		$159.56	$232.87	$307.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.01 / $18.01 / $53.59	Facility		$18.01	$18.01	$53.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.77 / $153.77 / $757.76	Facility		$153.77	$153.77	$757.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $288.75 / $360.94	Professional		$130.69	$288.75	$360.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.02 / $68.58 / $250.22	Facility		$15.02	$68.58	$250.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $30.05 / $30.05 / $119.71	Professional		$30.05	$30.05	$119.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.80 / $196.57 / $1,123.95	Facility		$24.80	$196.57	$1,123.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.93 / $117.94 / $208.71	Professional		$80.93	$117.94	$208.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $15.02 / $146.54 / $250.22	Facility		$15.02	$146.54	$250.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $30.05 / $30.05 / $119.71	Professional		$30.05	$30.05	$119.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.12 / $49.69 / $64.52	Professional		$28.12	$49.69	$64.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $153.77 / $404.58 / $1,123.95	Facility		$153.77	$404.58	$1,123.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.44 / $153.77 / $153.77	Professional		$18.44	$153.77	$153.77
United Facility/Professional Professional Modifier Low / Median / High Price $80.93 / $117.94 / $196.57	Professional		$80.93	$117.94	$196.57