Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.05 / $164.84 / $622.04	Facility		$85.05	$164.84	$622.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.83 / $119.74 / $285.00	Professional		$81.83	$119.74	$285.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $103.23 / $103.23 / $103.23	Facility		$103.23	$103.23	$103.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.58 / $82.58 / $104.87	Professional		$82.58	$82.58	$104.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $113.06 / $113.06 / $132.13	Facility		$113.06	$113.06	$132.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.57 / $194.52 / $278.05	Facility		$82.57	$194.52	$278.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.95 / $126.58 / $143.84	Professional		$80.95	$126.58	$143.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $82.42 / $98.94	Facility		$75.51	$82.42	$98.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $56.92 / $165.16 / $165.16	Professional		$56.92	$165.16	$165.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.42 / $88.36 / $368.65	Facility		$82.42	$88.36	$368.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.42 / $82.42 / $165.16	Professional		$82.42	$82.42	$165.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $77.16 / $85.00	Professional		$65.00	$77.16	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $82.42 / $98.94	Facility		$75.51	$82.42	$98.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $56.92 / $165.16 / $165.16	Professional		$56.92	$165.16	$165.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.57 / $119.59 / $258.00	Professional		$82.57	$119.59	$258.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $82.57 / $82.57 / $368.04	Facility		$82.57	$82.57	$368.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.57 / $82.57 / $82.57	Professional		$82.57	$82.57	$82.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.75 / $115.94 / $130.01	Professional		$102.75	$115.94	$130.01
United Facility/Professional Professional Modifier Low / Median / High Price $82.58 / $82.58 / $123.87	Professional		$82.58	$82.58	$123.87