Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.09 / $351.64 / $6,767.13	Facility		$181.09	$351.64	$6,767.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.21 / $186.66 / $449.57	Professional		$181.21	$186.66	$449.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $226.53 / $335.26 / $404.12	Facility		$226.53	$335.26	$404.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.22 / $181.22 / $230.14	Professional		$181.22	$181.22	$230.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $248.11 / $248.11 / $289.95	Facility		$248.11	$248.11	$289.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.22 / $424.32 / $606.54	Facility		$181.22	$424.32	$606.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.22 / $277.29 / $315.10	Professional		$181.22	$277.29	$315.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $155.99 / $175.82 / $399.19	Facility		$155.99	$175.82	$399.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $138.15 / $362.44 / $362.44	Professional		$138.15	$362.44	$362.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $155.99 / $175.82 / $387.77	Facility		$155.99	$175.82	$387.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $175.82 / $175.82 / $362.44	Professional		$175.82	$175.82	$362.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $174.80	Professional		$65.00	$85.00	$174.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $155.99 / $175.82 / $399.19	Facility		$155.99	$175.82	$399.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $138.15 / $362.44 / $362.44	Professional		$138.15	$362.44	$362.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.22 / $270.95 / $537.00	Professional		$181.22	$270.95	$537.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $874.00 / $874.00 / $874.00	Facility		$874.00	$874.00	$874.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.22 / $181.22 / $181.22	Professional		$181.22	$181.22	$181.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $212.19 / $254.43 / $268.48	Professional		$212.19	$254.43	$268.48
United Facility/Professional Professional Modifier Low / Median / High Price $181.22 / $181.22 / $271.83	Professional		$181.22	$181.22	$271.83