Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.53 / $327.85 / $386.17	Facility		$169.53	$327.85	$386.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $169.53 / $445.69	Professional		$164.59	$169.53	$445.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $205.74 / $304.49 / $367.04	Facility		$205.74	$304.49	$367.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $236.34	Professional		$164.59	$164.59	$236.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $225.34 / $225.34 / $263.33	Facility		$225.34	$225.34	$263.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $209.63 / $465.51	Facility		$164.59	$209.63	$465.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.39 / $264.35 / $300.39	Professional		$166.39	$264.35	$300.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $153.35 / $168.13 / $362.83	Facility		$153.35	$168.13	$362.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $252.20 / $329.18 / $329.18	Professional		$252.20	$329.18	$329.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $153.35 / $168.13 / $417.83	Facility		$153.35	$168.13	$417.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.13 / $168.13 / $329.18	Professional		$168.13	$168.13	$329.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $163.30	Professional		$65.00	$85.00	$163.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $153.35 / $168.13 / $362.83	Facility		$153.35	$168.13	$362.83
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $252.20 / $329.18 / $329.18	Professional		$252.20	$329.18	$329.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $174.47 / $564.29	Professional		$164.59	$174.47	$564.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $850.55 / $850.55 / $850.55	Facility		$850.55	$850.55	$850.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $164.59	Professional		$164.59	$164.59	$164.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $208.80 / $231.08 / $231.08	Professional		$208.80	$231.08	$231.08
United Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $233.73	Professional		$164.59	$164.59	$233.73