Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.63 / $273.83 / $322.55	Facility		$144.63	$273.83	$322.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $145.22 / $241.26	Professional		$140.99	$145.22	$241.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $176.24 / $260.83 / $314.41	Facility		$176.24	$260.83	$314.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $179.05	Professional		$140.99	$140.99	$179.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $193.03 / $193.03 / $225.58	Facility		$193.03	$193.03	$225.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.99 / $341.41 / $488.02	Facility		$140.99	$341.41	$488.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.90 / $205.58 / $233.61	Professional		$140.90	$205.58	$233.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $140.43 / $140.43 / $310.80	Facility		$140.43	$140.43	$310.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $210.65 / $281.98 / $281.98	Professional		$210.65	$281.98	$281.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.43 / $140.43 / $309.36	Facility		$140.43	$140.43	$309.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.43 / $156.33 / $281.98	Professional		$140.43	$156.33	$281.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $134.26	Professional		$65.00	$85.00	$134.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $140.43 / $140.43 / $310.80	Facility		$140.43	$140.43	$310.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $210.65 / $281.98 / $281.98	Professional		$210.65	$281.98	$281.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $208.10 / $456.01	Professional		$140.99	$208.10	$456.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $140.99 / $140.99 / $671.30	Facility		$140.99	$140.99	$671.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $140.99	Professional		$140.99	$140.99	$140.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $197.95 / $197.95 / $197.95	Professional		$197.95	$197.95	$197.95
United Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $156.94 / $197.39	Professional		$140.99	$156.94	$197.39