Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.60 / $153.60 / $342.53	Facility		$153.60	$153.60	$342.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.60 / $153.60 / $192.00	Professional		$153.60	$153.60	$192.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $307.20 / $357.03 / $370.31	Facility		$307.20	$357.03	$370.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $163.19	Professional		$160.00	$160.00	$163.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $192.00 / $436.94	Facility		$160.00	$192.00	$436.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.01 / $164.81 / $200.02	Professional		$160.01	$164.81	$200.02
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $153.60 / $192.00 / $192.00	Facility		$153.60	$192.00	$192.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $153.60 / $192.00 / $192.00	Facility		$153.60	$192.00	$192.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $208.00	Professional		$160.00	$160.00	$208.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $153.60 / $192.00 / $192.00	Facility		$153.60	$192.00	$192.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $831.15 / $831.15 / $831.15	Facility		$831.15	$831.15	$831.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $208.00	Professional		$160.00	$160.00	$208.00