Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.81 / $194.65 / $229.27	Facility		$102.81	$194.65	$229.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $102.97 / $256.33	Professional		$99.97	$102.97	$256.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.96 / $184.94 / $222.93	Facility		$124.96	$184.94	$222.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $99.97 / $126.96	Professional		$99.97	$99.97	$126.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $136.87 / $136.87 / $159.94	Facility		$136.87	$136.87	$159.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.97 / $117.13 / $275.05	Facility		$99.97	$117.13	$275.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.91 / $155.93 / $177.19	Professional		$100.91	$155.93	$177.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $99.82 / $99.82 / $220.27	Facility		$99.82	$99.82	$220.27
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $149.72 / $199.94 / $199.94	Professional		$149.72	$199.94	$199.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.82 / $99.82 / $220.27	Facility		$99.82	$99.82	$220.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $99.82 / $99.82 / $199.94	Professional		$99.82	$99.82	$199.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $99.04	Professional		$65.00	$85.00	$99.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $99.82 / $99.82 / $220.27	Facility		$99.82	$99.82	$220.27
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $149.72 / $199.94 / $199.94	Professional		$149.72	$199.94	$199.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $131.52 / $336.60	Professional		$99.97	$131.52	$336.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $495.20 / $495.20 / $495.20	Facility		$495.20	$495.20	$495.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $99.97 / $99.97	Professional		$99.97	$99.97	$99.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $140.36 / $140.36 / $140.36	Professional		$140.36	$140.36	$140.36
United Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $99.97 / $129.96	Professional		$99.97	$99.97	$129.96