Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.68 / $142.90 / $3,024.00	Facility		$70.68	$142.90	$3,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $142.90 / $201.17	Professional		$138.74	$142.90	$201.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $138.74 / $215.04	Professional		$138.74	$138.74	$215.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $189.95 / $220.60 / $221.98	Facility		$189.95	$220.60	$221.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $183.29 / $335.31 / $475.25	Facility		$183.29	$335.31	$475.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $173.67 / $264.19	Professional		$138.74	$173.67	$264.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $132.79 / $138.74 / $214.35	Facility		$132.79	$138.74	$214.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $132.79 / $140.26 / $312.17	Facility		$132.79	$140.26	$312.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.18 / $136.18 / $285.98	Professional		$136.18	$136.18	$285.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $170.56	Professional		$50.00	$70.00	$170.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $132.79 / $138.74 / $214.35	Facility		$132.79	$138.74	$214.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $152.63 / $339.77	Professional		$138.74	$152.63	$339.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $136.37 / $460.72 / $612.61	Facility		$136.37	$460.72	$612.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $196.35 / $1,448.75	Professional		$138.74	$196.35	$1,448.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.06 / $194.79 / $204.27	Professional		$152.06	$194.79	$204.27
United Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $138.74 / $180.36	Professional		$138.74	$138.74	$180.36