Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.71 / $228.52 / $269.18	Facility		$120.71	$228.52	$269.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $120.88 / $280.02	Professional		$117.36	$120.88	$280.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.69 / $217.12 / $261.70	Facility		$146.69	$217.12	$261.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $149.04	Professional		$117.36	$117.36	$149.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $160.68 / $160.68 / $187.78	Facility		$160.68	$160.68	$187.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.32 / $137.53 / $312.01	Facility		$116.32	$137.53	$312.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $174.80 / $198.64	Professional		$117.36	$174.80	$198.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $117.19 / $117.19 / $258.75	Facility		$117.19	$117.19	$258.75
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $175.79 / $234.72 / $234.72	Professional		$175.79	$234.72	$234.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.19 / $117.19 / $258.04	Facility		$117.19	$117.19	$258.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.19 / $117.19 / $234.72	Professional		$117.19	$117.19	$234.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $116.47	Professional		$65.00	$85.00	$116.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $117.19 / $117.19 / $258.75	Facility		$117.19	$117.19	$258.75
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $175.79 / $234.72 / $234.72	Professional		$175.79	$234.72	$234.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $124.40 / $392.70	Professional		$117.36	$124.40	$392.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $582.35 / $582.35 / $582.35	Facility		$582.35	$582.35	$582.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $117.36	Professional		$117.36	$117.36	$117.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $164.77 / $164.77 / $164.77	Professional		$164.77	$164.77	$164.77
United Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $152.57	Professional		$117.36	$117.36	$152.57