Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.18 / $326.42 / $374.86	Facility		$169.18	$326.42	$374.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $165.90 / $197.10	Professional		$164.25	$165.90	$197.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $205.31 / $303.86 / $366.28	Facility		$205.31	$303.86	$366.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $221.73	Professional		$164.25	$164.25	$221.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $262.80 / $295.64 / $301.05	Facility		$262.80	$295.64	$301.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.25 / $231.40 / $423.32	Facility		$164.25	$231.40	$423.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.79 / $193.92 / $285.81	Professional		$159.79	$193.92	$285.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $136.07 / $164.25 / $180.68	Facility		$136.07	$164.25	$180.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $244.82 / $328.50 / $328.50	Professional		$244.82	$328.50	$328.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $136.07 / $163.21 / $181.32	Facility		$136.07	$163.21	$181.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $163.21 / $181.69 / $3,623.57	Professional		$163.21	$181.69	$3,623.57
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 $127.01 / $164.25 / $180.68	Facility		$127.01	$164.25	$180.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $244.82 / $328.50 / $328.50	Professional		$244.82	$328.50	$328.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $212.26 / $471.00	Professional		$164.25	$212.26	$471.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $161.94 / $164.25 / $761.40	Facility		$161.94	$164.25	$761.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $280.57 / $3,623.57	Professional		$164.25	$280.57	$3,623.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $163.21 / $163.21 / $163.21	Professional		$163.21	$163.21	$163.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $137.69 / $226.78 / $230.61	Professional		$137.69	$226.78	$230.61
United Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $174.11 / $195.46	Professional		$164.25	$174.11	$195.46