Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.10 / $335.28 / $515.82	Facility		$177.10	$335.28	$515.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $177.39 / $338.66	Professional		$172.22	$177.39	$338.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $215.28 / $318.61 / $384.05	Facility		$215.28	$318.61	$384.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $218.71	Professional		$172.22	$172.22	$218.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $235.78 / $235.78 / $275.55	Facility		$235.78	$235.78	$275.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.22 / $382.86 / $547.28	Facility		$172.22	$382.86	$547.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.49 / $238.79 / $271.35	Professional		$170.49	$238.79	$271.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $171.94 / $379.24	Facility		$111.95	$171.94	$379.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $257.91 / $344.44 / $344.44	Professional		$257.91	$344.44	$344.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.99 / $171.94 / $353.77	Facility		$114.99	$171.94	$353.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $171.94 / $171.94 / $344.44	Professional		$171.94	$171.94	$344.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $162.46	Professional		$65.00	$85.00	$162.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $171.94 / $379.24	Facility		$111.95	$171.94	$379.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $257.91 / $344.44 / $344.44	Professional		$257.91	$344.44	$344.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $197.12 / $502.00	Professional		$172.22	$197.12	$502.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $812.30 / $812.30 / $812.30	Facility		$812.30	$812.30	$812.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $172.22	Professional		$172.22	$172.22	$172.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.27 / $241.80 / $241.80	Professional		$152.27	$241.80	$241.80
United Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $265.51	Professional		$172.22	$172.22	$265.51