Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.08 / $182.04 / $38,806.10	Facility		$94.08	$182.04	$38,806.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $92.25 / $125.43	Professional		$91.34	$92.25	$125.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.18 / $168.98 / $203.69	Facility		$114.18	$168.98	$203.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $91.34 / $123.30	Professional		$91.34	$91.34	$123.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.02 / $127.43 / $167.41	Facility		$91.02	$127.43	$167.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $91.34 / $211.77	Professional		$91.02	$91.34	$211.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.34 / $115.41 / $239.92	Facility		$91.34	$115.41	$239.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $109.44 / $166.91	Professional		$91.34	$109.44	$166.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $81.06 / $91.34 / $100.47	Facility		$81.06	$91.34	$100.47
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $136.53 / $182.68 / $182.68	Professional		$136.53	$182.68	$182.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.06 / $91.02 / $101.30	Facility		$81.06	$91.02	$101.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $101.32 / $389.52	Professional		$91.02	$101.32	$389.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $81.06 / $91.34 / $100.47	Facility		$81.06	$91.34	$100.47
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $136.53 / $182.68 / $182.68	Professional		$136.53	$182.68	$182.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $138.56 / $273.00	Professional		$91.34	$138.56	$273.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $91.34 / $95.64 / $446.95	Facility		$91.34	$95.64	$446.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $162.30 / $389.52	Professional		$91.34	$162.30	$389.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.20 / $128.24 / $131.18	Professional		$97.20	$128.24	$131.18
United Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $96.82 / $116.93	Professional		$91.34	$96.82	$116.93