Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.06 / $104.06 / $3,730.23	Facility		$104.06	$104.06	$3,730.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $104.06 / $127.29	Professional		$101.03	$104.06	$127.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.91 / $217.21 / $225.30	Facility		$186.91	$217.21	$225.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $156.59	Professional		$101.03	$101.03	$156.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.32 / $149.52 / $161.65	Facility		$138.32	$149.52	$161.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.97 / $257.89 / $365.53	Facility		$140.97	$257.89	$365.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $134.30 / $201.11	Professional		$101.03	$134.30	$201.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $98.54 / $102.04 / $156.09	Facility		$98.54	$102.04	$156.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.54 / $101.50 / $227.32	Facility		$98.54	$101.50	$227.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.54 / $98.54 / $252.73	Professional		$98.54	$98.54	$252.73
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 $98.54 / $102.04 / $156.09	Facility		$98.54	$102.04	$156.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $116.26 / $258.98	Professional		$101.03	$116.26	$258.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $105.46 / $438.08 / $547.60	Facility		$105.46	$438.08	$547.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $149.57 / $466.64	Professional		$101.03	$149.57	$466.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.76 / $141.85 / $141.85	Professional		$74.76	$141.85	$141.85
United Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $131.34	Professional		$101.03	$101.03	$131.34