Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.38 / $277.33 / $318.51	Facility		$143.38	$277.33	$318.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $140.60 / $167.05	Professional		$139.21	$140.60	$167.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.01 / $257.54 / $310.44	Facility		$174.01	$257.54	$310.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $187.93	Professional		$139.21	$139.21	$187.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $222.74 / $250.58 / $255.16	Facility		$222.74	$250.58	$255.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.21 / $203.86 / $372.94	Facility		$139.21	$203.86	$372.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $172.93 / $251.46	Professional		$139.21	$172.93	$251.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.55 / $139.21 / $156.41	Facility		$70.55	$139.21	$156.41
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $208.01 / $278.42 / $278.42	Professional		$208.01	$278.42	$278.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.55 / $138.66 / $159.54	Facility		$70.55	$138.66	$159.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.66 / $154.37 / $2,513.09	Professional		$138.66	$154.37	$2,513.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $70.55 / $139.21 / $167.05	Facility		$70.55	$139.21	$167.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $208.01 / $278.42 / $278.42	Professional		$208.01	$278.42	$278.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $151.88 / $422.00	Professional		$139.21	$151.88	$422.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $136.99 / $139.21 / $681.05	Facility		$136.99	$139.21	$681.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $250.98 / $2,513.09	Professional		$139.21	$250.98	$2,513.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $96.12 / $195.45 / $195.45	Professional		$96.12	$195.45	$195.45
United Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $146.16 / $165.66	Professional		$139.21	$146.16	$165.66