Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.17 / $157.46 / $185.47	Facility		$83.17	$157.46	$185.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.91 / $83.34 / $138.72	Professional		$80.91	$83.34	$138.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.14 / $149.68 / $180.43	Facility		$101.14	$149.68	$180.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.91 / $80.91 / $102.75	Professional		$80.91	$80.91	$102.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $110.77 / $110.77 / $129.46	Facility		$110.77	$110.77	$129.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.67 / $94.79 / $216.37	Facility		$80.67	$94.79	$216.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.67 / $118.56 / $134.72	Professional		$80.67	$118.56	$134.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $80.75 / $80.75 / $178.21	Facility		$80.75	$80.75	$178.21
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $121.13 / $161.82 / $161.82	Professional		$121.13	$161.82	$161.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.75 / $80.75 / $178.21	Facility		$80.75	$80.75	$178.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $80.75 / $161.82	Professional		$80.75	$80.75	$161.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $77.81 / $85.00	Professional		$77.81	$77.81	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $80.75 / $80.75 / $178.21	Facility		$80.75	$80.75	$178.21
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $121.13 / $161.82 / $161.82	Professional		$121.13	$161.82	$161.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.91 / $120.62 / $260.42	Professional		$80.91	$120.62	$260.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $389.10 / $389.10 / $389.10	Facility		$389.10	$389.10	$389.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.91 / $80.91 / $80.91	Professional		$80.91	$80.91	$80.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $113.60 / $113.60 / $113.60	Professional		$113.60	$113.60	$113.60
United Facility/Professional Professional Modifier Low / Median / High Price $80.91 / $80.91 / $105.18	Professional		$80.91	$80.91	$105.18