Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.90 / $109.90 / $2,308.23	Facility		$109.90	$109.90	$2,308.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $109.90 / $123.77	Professional		$106.70	$109.90	$123.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $160.05	Professional		$106.70	$106.70	$160.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $146.08 / $169.65 / $170.72	Facility		$146.08	$169.65	$170.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.25 / $370.00 / $524.41	Facility		$202.25	$370.00	$524.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $106.70 / $306.68	Professional		$39.36	$106.70	$306.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $109.90 / $168.15	Facility		$89.18	$109.90	$168.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $91.86 / $479.40	Facility		$89.18	$91.86	$479.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.18 / $89.18 / $563.96	Professional		$89.18	$89.18	$563.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $91.50	Professional		$50.00	$70.00	$91.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $109.90 / $168.15	Facility		$89.18	$109.90	$168.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $115.76 / $480.36	Professional		$106.70	$115.76	$480.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $479.40 / $604.19	Facility		$65.00	$479.40	$604.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $461.44 / $1,448.75	Professional		$106.70	$461.44	$1,448.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $149.81 / $149.81 / $177.12	Professional		$149.81	$149.81	$177.12
United Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $138.71	Professional		$106.70	$106.70	$138.71