Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.26 / $126.76 / $145.57	Facility		$82.26	$126.76	$145.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $82.26 / $108.89	Professional		$79.86	$82.26	$108.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.83 / $147.74 / $178.09	Facility		$99.83	$147.74	$178.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $107.81	Professional		$79.86	$79.86	$107.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.78 / $143.75 / $146.38	Facility		$127.78	$143.75	$146.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $110.27 / $201.73	Facility		$79.86	$110.27	$201.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.25 / $80.48 / $217.91	Professional		$68.25	$80.48	$217.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.38 / $82.26 / $165.27	Facility		$63.38	$82.26	$165.27
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.73 / $159.72 / $159.72	Professional		$61.73	$159.72	$159.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.38 / $65.28 / $139.77	Facility		$63.38	$65.28	$139.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.38 / $70.56 / $4,956.64	Professional		$63.38	$70.56	$4,956.64
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 $63.38 / $82.26 / $165.27	Facility		$63.38	$82.26	$165.27
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $61.73 / $159.72 / $159.72	Professional		$61.73	$159.72	$159.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $97.94 / $262.32	Professional		$79.86	$97.94	$262.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $79.86 / $760.75	Facility		$79.86	$79.86	$760.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $152.15 / $4,956.64	Professional		$79.86	$152.15	$4,956.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.12 / $112.12 / $240.44	Professional		$112.12	$112.12	$240.44
United Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $83.85 / $101.03	Professional		$79.86	$83.85	$101.03