Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.15 / $147.10 / $168.92	Facility		$76.15	$147.10	$168.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $74.67 / $88.72	Professional		$73.94	$74.67	$88.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.43 / $136.77 / $164.86	Facility		$92.43	$136.77	$164.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $73.94 / $99.81	Professional		$73.94	$73.94	$99.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $118.30 / $133.09 / $135.53	Facility		$118.30	$133.09	$135.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.94 / $107.02 / $195.79	Facility		$73.94	$107.02	$195.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.84 / $89.63 / $130.75	Professional		$73.84	$89.63	$130.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $62.36 / $73.94 / $81.33	Facility		$62.36	$73.94	$81.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $110.33 / $147.88 / $147.88	Professional		$110.33	$147.88	$147.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.36 / $73.55 / $81.08	Facility		$62.36	$73.55	$81.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.55 / $81.88 / $310.70	Professional		$73.55	$81.88	$310.70
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 $57.65 / $73.94 / $81.33	Facility		$57.65	$73.94	$81.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $110.33 / $147.88 / $147.88	Professional		$110.33	$147.88	$147.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $95.09 / $218.00	Professional		$73.94	$95.09	$218.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.94 / $85.00 / $351.90	Facility		$73.94	$85.00	$351.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $129.46 / $310.70	Professional		$73.94	$129.46	$310.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.56 / $103.81 / $103.81	Professional		$62.56	$103.81	$103.81
United Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $73.94 / $87.99	Professional		$73.94	$73.94	$87.99