Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.81 / $315.82 / $371.99	Facility		$166.81	$315.82	$371.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $170.81 / $293.27	Professional		$165.83	$170.81	$293.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $207.29 / $306.79 / $369.80	Facility		$207.29	$306.79	$369.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $210.60	Professional		$165.83	$165.83	$210.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $227.04 / $227.04 / $265.33	Facility		$227.04	$227.04	$265.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.83 / $238.85 / $436.94	Facility		$165.83	$238.85	$436.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.46 / $232.29 / $263.95	Professional		$166.46	$232.29	$263.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $161.96 / $161.96 / $365.69	Facility		$161.96	$161.96	$365.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $242.94 / $331.66 / $331.66	Professional		$242.94	$331.66	$331.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $161.94 / $161.96 / $357.14	Facility		$161.94	$161.96	$357.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $161.96 / $161.96 / $331.66	Professional		$161.96	$161.96	$331.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $163.37	Professional		$65.00	$85.00	$163.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $161.96 / $161.96 / $365.69	Facility		$161.96	$161.96	$365.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $242.94 / $331.66 / $331.66	Professional		$242.94	$331.66	$331.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $207.16 / $530.20	Professional		$165.83	$207.16	$530.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $165.83 / $165.83 / $816.85	Facility		$165.83	$165.83	$816.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $165.83	Professional		$165.83	$165.83	$165.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $232.83 / $232.83 / $232.83	Professional		$232.83	$232.83	$232.83
United Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $215.58	Professional		$165.83	$165.83	$215.58