Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.68 / $163.68 / $163.68	Facility		$163.68	$163.68	$163.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $163.68 / $190.70	Professional		$158.91	$163.68	$190.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $238.38	Professional		$158.91	$158.91	$238.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $217.58 / $235.20 / $254.27	Facility		$217.58	$235.20	$254.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $360.08 / $514.71	Facility		$158.91	$360.08	$514.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.58 / $228.75 / $259.94	Professional		$151.58	$228.75	$259.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $158.91 / $294.62	Facility		$158.91	$158.91	$294.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $171.87 / $654.50	Facility		$158.91	$171.87	$654.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.19 / $158.91 / $229.39	Professional		$119.19	$158.91	$229.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $158.91	Professional		$50.00	$65.00	$158.91
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $158.91 / $294.62	Facility		$158.91	$158.91	$294.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $179.63 / $494.91	Professional		$158.91	$179.63	$494.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $152.91 / $152.91 / $654.50	Facility		$152.91	$152.91	$654.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $152.91 / $158.91 / $158.91	Professional		$152.91	$158.91	$158.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $158.91	Professional		$158.91	$158.91	$158.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.74 / $223.12 / $223.12	Professional		$173.74	$223.12	$223.12
United Facility/Professional Professional Modifier Low / Median / High Price $135.08 / $158.91 / $232.09	Professional		$135.08	$158.91	$232.09