Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.47 / $166.47 / $166.47	Facility		$166.47	$166.47	$166.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $166.47 / $177.79	Professional		$161.62	$166.47	$177.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $242.43	Professional		$161.62	$161.62	$242.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $221.28 / $256.98 / $258.58	Facility		$221.28	$256.98	$258.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $373.44 / $478.00 / $653.32	Facility		$373.44	$478.00	$653.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $167.72 / $215.16	Professional		$161.62	$167.72	$215.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $166.47 / $278.51	Facility		$161.62	$166.47	$278.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $164.84 / $169.78 / $305.60	Facility		$164.84	$169.78	$305.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.84 / $164.84 / $446.65	Professional		$164.84	$164.84	$446.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $412.16	Professional		$50.00	$70.00	$412.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $166.47 / $278.51	Facility		$161.62	$166.47	$278.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $175.35 / $424.91	Professional		$161.62	$175.35	$424.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $168.92 / $379.65 / $1,674.94	Facility		$168.92	$379.65	$1,674.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $401.99 / $1,697.27	Professional		$161.62	$401.99	$1,697.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $226.91 / $226.91 / $226.91	Professional		$226.91	$226.91	$226.91
United Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $210.11	Professional		$161.62	$161.62	$210.11