Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.72 / $251.01 / $327.84	Facility		$111.72	$251.01	$327.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $111.72 / $151.86	Professional		$108.47	$111.72	$151.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.67 / $233.21 / $241.89	Facility		$200.67	$233.21	$241.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $162.69	Professional		$108.47	$108.47	$162.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $148.50 / $160.54 / $173.55	Facility		$148.50	$160.54	$173.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $178.12 / $370.28	Facility		$108.47	$178.12	$370.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $133.31 / $191.58	Professional		$108.47	$133.31	$191.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $111.72 / $350.41	Facility		$108.47	$111.72	$350.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.28 / $112.56 / $350.41	Facility		$109.28	$112.56	$350.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.28 / $121.65 / $1,698.40	Professional		$109.28	$121.65	$1,698.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $85.00 / $109.28	Professional		$58.40	$85.00	$109.28
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $111.72 / $350.41	Facility		$108.47	$111.72	$350.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $168.84 / $478.09	Professional		$108.47	$168.84	$478.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $163.28 / $1,578.65	Facility		$108.47	$163.28	$1,578.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $315.73 / $1,698.40	Professional		$108.47	$315.73	$1,698.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.29 / $152.29 / $603.13	Professional		$152.29	$152.29	$603.13
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $111.72 / $136.66	Professional		$108.47	$111.72	$136.66