Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.78 / $152.94 / $180.14	Facility		$80.78	$152.94	$180.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $81.30 / $134.74	Professional		$78.93	$81.30	$134.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.66 / $146.02 / $176.01	Facility		$98.66	$146.02	$176.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $78.93 / $100.24	Professional		$78.93	$78.93	$100.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.07 / $108.07 / $126.29	Facility		$108.07	$108.07	$126.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $192.01 / $274.47	Facility		$78.93	$192.01	$274.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.23 / $125.98 / $143.16	Professional		$81.23	$125.98	$143.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $78.43 / $78.43 / $173.94	Facility		$78.43	$78.43	$173.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $117.65 / $157.86 / $157.86	Professional		$117.65	$157.86	$157.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.43 / $78.43 / $172.52	Facility		$78.43	$78.43	$172.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $78.43 / $78.43 / $157.86	Professional		$78.43	$78.43	$157.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.73 / $79.73 / $85.00	Professional		$79.73	$79.73	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $78.43 / $78.43 / $173.94	Facility		$78.43	$78.43	$173.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $117.65 / $157.86 / $157.86	Professional		$117.65	$157.86	$157.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $122.88 / $269.07	Professional		$78.93	$122.88	$269.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $78.93 / $398.70	Facility		$78.93	$78.93	$398.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $78.93 / $78.93	Professional		$78.93	$78.93	$78.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $110.82 / $110.82 / $110.82	Professional		$110.82	$110.82	$110.82
United Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $78.93 / $108.07	Professional		$78.93	$78.93	$108.07