Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.88 / $100.88 / $100.88	Facility		$100.88	$100.88	$100.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $100.88 / $107.73	Professional		$97.94	$100.88	$107.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.19 / $210.57 / $218.41	Facility		$181.19	$210.57	$218.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $151.80	Professional		$97.94	$97.94	$151.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.09 / $144.94 / $156.69	Facility		$134.09	$144.94	$156.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.54 / $189.42 / $268.47	Facility		$103.54	$189.42	$268.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $127.59 / $241.94	Professional		$97.94	$127.59	$241.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $87.37 / $100.88 / $151.32	Facility		$87.37	$100.88	$151.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.37 / $111.15 / $238.09	Facility		$87.37	$111.15	$238.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.92 / $107.92 / $226.63	Professional		$107.92	$107.92	$226.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $87.37 / $100.88 / $151.32	Facility		$87.37	$100.88	$151.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $113.07 / $251.86	Professional		$97.94	$113.07	$251.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.17 / $412.40 / $774.00	Facility		$100.17	$412.40	$774.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $185.76 / $784.32	Professional		$97.94	$185.76	$784.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.84 / $137.51 / $137.51	Professional		$94.84	$137.51	$137.51
United Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $127.32	Professional		$97.94	$97.94	$127.32