Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.03 / $246.17 / $289.97	Facility		$130.03	$246.17	$289.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $131.28 / $355.46	Professional		$127.45	$131.28	$355.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.31 / $235.78 / $284.20	Facility		$159.31	$235.78	$284.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $161.86	Professional		$127.45	$127.45	$161.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $174.49 / $174.49 / $203.92	Facility		$174.49	$174.49	$203.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.45 / $162.33 / $378.16	Facility		$127.45	$162.33	$378.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.94 / $219.37 / $249.29	Professional		$133.94	$219.37	$249.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $126.24 / $126.24 / $280.85	Facility		$126.24	$126.24	$280.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $189.36 / $254.90 / $254.90	Professional		$189.36	$254.90	$254.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.24 / $126.24 / $278.02	Facility		$126.24	$126.24	$278.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.24 / $126.24 / $254.90	Professional		$126.24	$126.24	$254.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $131.46	Professional		$65.00	$85.00	$131.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $126.24 / $126.24 / $280.85	Facility		$126.24	$126.24	$280.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $189.36 / $254.90 / $254.90	Professional		$189.36	$254.90	$254.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $135.10 / $453.20	Professional		$127.45	$135.10	$453.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,102.17 / $1,102.17 / $1,102.17	Facility		$1,102.17	$1,102.17	$1,102.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $127.45	Professional		$127.45	$127.45	$127.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $178.94 / $178.94 / $178.94	Professional		$178.94	$178.94	$178.94
United Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $178.43	Professional		$127.45	$127.45	$178.43