Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.91 / $105.91 / $105.91	Facility		$105.91	$105.91	$105.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.62 / $80.59 / $127.26	Professional		$67.62	$80.59	$127.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.60 / $234.05 / $234.05	Facility		$128.60	$234.05	$234.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.45 / $119.60 / $160.75	Professional		$104.45	$119.60	$160.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.06 / $27.52 / $54.31	Facility		$9.06	$27.52	$54.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.70 / $88.70 / $360.45	Facility		$88.70	$88.70	$360.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.40 / $157.50 / $196.88	Professional		$75.40	$157.50	$196.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.59 / $30.46 / $158.87	Facility		$19.59	$30.46	$158.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $16.86 / $16.86 / $30.46	Professional		$16.86	$16.86	$30.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.30 / $105.91 / $206.60	Facility		$20.30	$105.91	$206.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $7.88 / $20.14 / $147.44	Professional		$7.88	$20.14	$147.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $55.00 / $65.00	Professional		$50.00	$55.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $20.30 / $80.59 / $158.87	Facility		$20.30	$80.59	$158.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $16.86 / $16.86 / $30.46	Professional		$16.86	$16.86	$30.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.35 / $28.40 / $36.86	Professional		$14.35	$28.40	$36.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $170.34 / $196.86	Facility		$65.00	$170.34	$196.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.41 / $88.70 / $98.28	Professional		$10.41	$88.70	$98.28
United Facility/Professional Professional Modifier Low / Median / High Price $7.12 / $14.81 / $144.30	Professional		$7.12	$14.81	$144.30