Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.26 / $120.26 / $120.26	Facility		$120.26	$120.26	$120.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.12 / $108.68 / $146.61	Professional		$78.12	$108.68	$146.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.30 / $289.93 / $289.93	Facility		$159.30	$289.93	$289.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.15 / $159.30 / $215.05	Professional		$148.15	$159.30	$215.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.23 / $34.09 / $379.46	Facility		$11.23	$34.09	$379.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $110.00 / $432.54	Facility		$110.00	$110.00	$432.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.50 / $187.50 / $234.38	Professional		$93.50	$187.50	$234.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.59 / $140.44 / $192.78	Facility		$28.59	$140.44	$192.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $29.83 / $29.83 / $165.23	Professional		$29.83	$29.83	$165.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.86 / $207.32 / $801.83	Facility		$24.86	$207.32	$801.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.87 / $133.91 / $206.54	Professional		$69.87	$133.91	$206.54
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 $28.59 / $140.44 / $192.78	Facility		$28.59	$140.44	$192.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $29.83 / $29.83 / $165.23	Professional		$29.83	$29.83	$165.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.79 / $35.50 / $46.09	Professional		$17.79	$35.50	$46.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $288.62 / $801.83	Facility		$110.00	$288.62	$801.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $110.00 / $112.20	Professional		$13.15	$110.00	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $66.77 / $111.96 / $193.36	Professional		$66.77	$111.96	$193.36