Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.83 / $228.96 / $1,123.02	Facility		$115.83	$228.96	$1,123.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $188.10 / $708.80	Professional		$112.45	$188.10	$708.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.56 / $208.03 / $250.76	Facility		$140.56	$208.03	$250.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $142.81	Professional		$112.45	$112.45	$142.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $153.96 / $153.96 / $179.92	Facility		$153.96	$153.96	$179.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $294.50 / $420.97	Facility		$112.45	$294.50	$420.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.13 / $198.54 / $225.61	Professional		$131.13	$198.54	$225.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $114.48 / $182.66	Facility		$112.45	$114.48	$182.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $77.76 / $224.90 / $224.90	Professional		$77.76	$224.90	$224.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.48 / $114.48 / $656.50	Facility		$114.48	$114.48	$656.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.48 / $114.48 / $224.90	Professional		$114.48	$114.48	$224.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $112.45 / $128.71	Professional		$65.00	$112.45	$128.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $114.48 / $182.66	Facility		$112.45	$114.48	$182.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $77.76 / $224.90 / $224.90	Professional		$77.76	$224.90	$224.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $175.05 / $373.00	Professional		$112.45	$175.05	$373.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $701.55 / $701.55 / $701.55	Facility		$701.55	$701.55	$701.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.88 / $157.88 / $223.05	Professional		$157.88	$157.88	$223.05
United Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $179.92	Professional		$112.45	$112.45	$179.92