Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.44 / $112.44 / $112.44	Facility		$112.44	$112.44	$112.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.44 / $130.81 / $166.12	Professional		$112.44	$130.81	$166.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.74 / $183.74 / $354.13	Professional		$183.74	$183.74	$354.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $176.50 / $176.50 / $176.50	Facility		$176.50	$176.50	$176.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $210.68 / $667.00 / $933.51	Facility		$210.68	$667.00	$933.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.80 / $401.63 / $502.03	Professional		$153.80	$401.63	$502.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.34 / $168.66 / $244.80	Facility		$109.34	$168.66	$244.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $186.52 / $186.52 / $186.52	Professional		$186.52	$186.52	$186.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.44 / $244.80 / $1,166.45	Facility		$112.44	$244.80	$1,166.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.13 / $173.67 / $284.04	Professional		$129.13	$173.67	$284.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $301.55	Professional		$50.00	$65.00	$301.55
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $109.34 / $168.66 / $244.80	Facility		$109.34	$168.66	$244.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $186.52 / $186.52 / $186.52	Professional		$186.52	$186.52	$186.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $283.24 / $519.82 / $674.95	Professional		$283.24	$519.82	$674.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $210.68 / $419.86 / $1,166.45	Facility		$210.68	$419.86	$1,166.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $153.80 / $210.68 / $1,545.97	Professional		$153.80	$210.68	$1,545.97
United Facility/Professional Professional Modifier Low / Median / High Price $118.92 / $145.80 / $253.20	Professional		$118.92	$145.80	$253.20