Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.36 / $252.68 / $297.64	Facility		$133.36	$252.68	$297.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $133.36 / $320.70	Professional		$129.47	$133.36	$320.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $161.85 / $239.54 / $288.74	Facility		$161.85	$239.54	$288.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $129.47 / $164.43	Professional		$129.47	$129.47	$164.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $177.27 / $177.27 / $207.17	Facility		$177.27	$177.27	$207.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.47 / $164.91 / $357.58	Facility		$129.47	$164.91	$357.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.93 / $198.22 / $225.25	Professional		$131.93	$198.22	$225.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $129.47 / $129.58 / $285.13	Facility		$129.47	$129.58	$285.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $194.37 / $258.95 / $258.95	Professional		$194.37	$258.95	$258.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $129.58 / $129.58 / $285.83	Facility		$129.58	$129.58	$285.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.58 / $129.58 / $258.95	Professional		$129.58	$129.58	$258.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $129.50	Professional		$65.00	$85.00	$129.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $129.47 / $129.58 / $285.13	Facility		$129.47	$129.58	$285.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $194.37 / $258.95 / $258.95	Professional		$194.37	$258.95	$258.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $171.06 / $437.80	Professional		$129.47	$171.06	$437.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $647.50 / $647.50 / $647.50	Facility		$647.50	$647.50	$647.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $129.47 / $129.47	Professional		$129.47	$129.47	$129.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $181.79 / $181.79 / $181.79	Professional		$181.79	$181.79	$181.79
United Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $129.47 / $177.28	Professional		$129.47	$129.47	$177.28