Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.54 / $163.82 / $245.73	Facility		$84.54	$163.82	$245.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.08 / $82.90 / $95.21	Professional		$82.08	$82.90	$95.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.60 / $151.83 / $183.02	Facility		$102.60	$151.83	$183.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.08 / $82.08 / $110.80	Professional		$82.08	$82.08	$110.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.33 / $147.74 / $150.44	Facility		$131.33	$147.74	$150.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.07 / $116.37 / $212.89	Facility		$82.07	$116.37	$212.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.30 / $97.45 / $129.16	Professional		$80.30	$97.45	$129.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $81.91 / $82.51 / $90.76	Facility		$81.91	$82.51	$90.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $122.87 / $164.16 / $164.16	Professional		$122.87	$164.16	$164.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.91 / $81.91 / $91.00	Facility		$81.91	$81.91	$91.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.91 / $91.18 / $337.90	Professional		$81.91	$91.18	$337.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $186.73	Professional		$50.00	$65.00	$186.73
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $81.91 / $82.08 / $91.35	Facility		$81.91	$82.08	$91.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $122.87 / $164.16 / $164.16	Professional		$122.87	$164.16	$164.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.08 / $118.62 / $256.10	Professional		$82.08	$118.62	$256.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $78.98 / $82.07 / $337.90	Facility		$78.98	$82.07	$337.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.07 / $140.79 / $337.90	Professional		$82.07	$140.79	$337.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $115.24 / $115.24 / $115.24	Professional		$115.24	$115.24	$115.24
United Facility/Professional Professional Modifier Low / Median / High Price $82.08 / $84.55 / $97.68	Professional		$82.08	$84.55	$97.68