Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $130.00 / $289.89	Facility		$130.00	$130.00	$289.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.00 / $130.00 / $162.50	Professional		$130.00	$130.00	$162.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.69 / $195.68 / $383.93	Professional		$111.69	$195.68	$383.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.80 / $340.42 / $486.61	Facility		$137.80	$340.42	$486.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.88 / $182.84 / $207.78	Professional		$142.88	$182.84	$207.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $108.96 / $130.00 / $234.52	Facility		$108.96	$130.00	$234.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $94.86 / $94.86 / $94.86	Professional		$94.86	$94.86	$94.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.96 / $130.00 / $234.52	Facility		$108.96	$130.00	$234.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $332.96 / $332.96 / $432.85	Professional		$332.96	$332.96	$432.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $390.08	Professional		$55.00	$65.00	$390.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $108.96 / $130.00 / $234.52	Facility		$108.96	$130.00	$234.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $94.86 / $94.86 / $94.86	Professional		$94.86	$94.86	$94.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.66 / $253.76 / $355.91	Professional		$177.66	$253.76	$355.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $137.80 / $137.80 / $582.30	Facility		$137.80	$137.80	$582.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $137.80 / $137.80 / $137.80	Professional		$137.80	$137.80	$137.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $198.97 / $251.76 / $363.79	Professional		$198.97	$251.76	$363.79
United Facility/Professional Professional Modifier Low / Median / High Price $332.96 / $332.96 / $499.44	Professional		$332.96	$332.96	$499.44