Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.22 / $274.95 / $323.86	Facility		$145.22	$274.95	$323.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $145.85 / $296.69	Professional		$141.60	$145.85	$296.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.00 / $261.95 / $315.77	Facility		$177.00	$261.95	$315.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $179.83	Professional		$141.60	$141.60	$179.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $193.87 / $193.87 / $226.56	Facility		$193.87	$193.87	$226.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $171.07 / $355.64	Facility		$141.60	$171.07	$355.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.13 / $193.91 / $220.35	Professional		$139.13	$193.91	$220.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.01 / $141.00 / $312.22	Facility		$102.01	$141.00	$312.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $211.50 / $283.20 / $283.20	Professional		$211.50	$283.20	$283.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.01 / $141.00 / $299.85	Facility		$102.01	$141.00	$299.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.00 / $141.00 / $283.20	Professional		$141.00	$141.00	$283.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $136.56	Professional		$65.00	$85.00	$136.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $102.01 / $141.00 / $312.22	Facility		$102.01	$141.00	$312.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $211.50 / $283.20 / $283.20	Professional		$211.50	$283.20	$283.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $150.10 / $453.85	Professional		$141.60	$150.10	$453.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $682.80 / $682.80 / $682.80	Facility		$682.80	$682.80	$682.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $198.81 / $202.05	Professional		$138.74	$198.81	$202.05
United Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $184.08	Professional		$141.60	$141.60	$184.08