Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.77 / $272.45 / $312.91	Facility		$140.77	$272.45	$312.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $140.77 / $187.68	Professional		$136.66	$140.77	$187.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.84 / $252.84 / $304.77	Facility		$170.84	$252.84	$304.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $184.50	Professional		$136.66	$136.66	$184.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.67 / $246.01 / $250.50	Facility		$218.67	$246.01	$250.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $259.60 / $450.34	Facility		$136.66	$259.60	$450.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $169.03 / $244.04	Professional		$136.66	$169.03	$244.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $136.66 / $151.13	Facility		$136.22	$136.66	$151.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $204.35 / $273.33 / $273.33	Professional		$204.35	$273.33	$273.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $136.22 / $150.65	Facility		$136.22	$136.22	$150.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $151.65 / $586.87	Professional		$136.22	$151.65	$586.87
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 $136.22 / $136.66 / $152.11	Facility		$136.22	$136.66	$152.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $204.35 / $273.33 / $273.33	Professional		$204.35	$273.33	$273.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $176.65 / $452.10	Professional		$136.66	$176.65	$452.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $135.60 / $136.66 / $663.65	Facility		$135.60	$136.66	$663.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $244.53 / $586.87	Professional		$136.66	$244.53	$586.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $168.64 / $191.88 / $191.88	Professional		$168.64	$191.88	$191.88
United Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $143.50 / $162.63	Professional		$136.66	$143.50	$162.63