Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.55 / $169.53 / $199.70	Facility		$89.55	$169.53	$199.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $89.90 / $149.36	Professional		$87.28	$89.90	$149.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.10 / $161.47 / $194.63	Facility		$109.10	$161.47	$194.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $110.84	Professional		$87.28	$87.28	$110.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $119.49 / $119.49 / $139.65	Facility		$119.49	$119.49	$139.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $95.56 / $198.66	Facility		$87.28	$95.56	$198.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.40 / $88.99 / $108.00	Professional		$86.40	$88.99	$108.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $86.94 / $86.94 / $192.47	Facility		$86.94	$86.94	$192.47
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $174.56 / $174.56	Professional		$130.41	$174.56	$174.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.94 / $86.94 / $191.76	Facility		$86.94	$86.94	$191.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.94 / $86.94 / $174.56	Professional		$86.94	$86.94	$174.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $84.80 / $206.91	Professional		$50.00	$84.80	$206.91
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $86.94 / $86.94 / $192.47	Facility		$86.94	$86.94	$192.47
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $174.56 / $174.56	Professional		$130.41	$174.56	$174.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $135.86	Professional		$87.28	$87.28	$135.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $393.25 / $393.25 / $393.25	Facility		$393.25	$393.25	$393.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $122.54 / $122.54 / $122.54	Professional		$122.54	$122.54	$122.54
United Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $113.46	Professional		$87.28	$87.28	$113.46