Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.64 / $154.81 / $182.35	Facility		$81.64	$154.81	$182.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $81.64 / $166.68	Professional		$79.26	$81.64	$166.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.08 / $146.63 / $176.75	Facility		$99.08	$146.63	$176.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $100.66	Professional		$79.26	$79.26	$100.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.52 / $108.52 / $126.82	Facility		$108.52	$108.52	$126.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.26 / $100.93 / $214.43	Facility		$79.26	$100.93	$214.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $116.38 / $132.25	Professional		$79.26	$116.38	$132.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $79.26 / $79.39 / $174.64	Facility		$79.26	$79.39	$174.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $119.09 / $158.52 / $158.52	Professional		$119.09	$158.52	$158.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.39 / $79.39 / $174.64	Facility		$79.39	$79.39	$174.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.39 / $79.39 / $158.52	Professional		$79.39	$79.39	$158.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $76.95 / $85.00	Professional		$65.00	$76.95	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $79.26 / $79.39 / $174.64	Facility		$79.26	$79.39	$174.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $119.09 / $158.52 / $158.52	Professional		$119.09	$158.52	$158.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $102.29 / $261.80	Professional		$79.26	$102.29	$261.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $79.26 / $79.26 / $384.75	Facility		$79.26	$79.26	$384.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $79.26	Professional		$79.26	$79.26	$79.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $111.28 / $111.28 / $111.28	Professional		$111.28	$111.28	$111.28
United Facility/Professional Facility Modifier Low / Median / High Price $79.20 / $79.20 / $79.20	Facility		$79.20	$79.20	$79.20
United Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $108.52	Professional		$79.26	$79.26	$108.52