Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.98 / $177.67 / $209.29	Facility		$88.98	$177.67	$209.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $849.59 / $1,960.00	Professional		$86.38	$849.59	$1,960.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.98 / $159.80 / $192.63	Facility		$107.98	$159.80	$192.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $109.70	Professional		$86.38	$86.38	$109.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $118.26 / $118.26 / $138.21	Facility		$118.26	$118.26	$138.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $332.92 / $475.88	Facility		$86.38	$332.92	$475.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.14 / $292.50 / $332.39	Professional		$92.14	$292.50	$332.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $91.11 / $419.90	Facility		$86.38	$91.11	$419.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $172.76 / $284.86	Professional		$136.66	$172.76	$284.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.11 / $91.11 / $419.90	Facility		$91.11	$91.11	$419.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.11 / $91.11 / $172.76	Professional		$91.11	$91.11	$172.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $90.41	Professional		$65.00	$85.00	$90.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $91.11 / $419.90	Facility		$86.38	$91.11	$419.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $172.76 / $284.86	Professional		$136.66	$172.76	$284.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $137.77 / $434.93	Professional		$86.38	$137.77	$434.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $86.38 / $1,621.35	Facility		$86.38	$86.38	$1,621.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Professional		$86.38	$86.38	$86.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.28 / $121.28 / $575.66	Professional		$121.28	$121.28	$575.66
United Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $129.57	Professional		$86.38	$86.38	$129.57