Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.10 / $155.57 / $311.13	Facility		$102.10	$155.57	$311.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.12 / $102.10 / $933.57	Professional		$99.12	$102.10	$933.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.39 / $213.13 / $221.06	Facility		$183.39	$213.13	$221.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $99.13 / $153.65	Professional		$99.13	$99.13	$153.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $146.71 / $158.61 / $181.69	Facility		$146.71	$158.61	$181.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $126.24 / $377.04	Facility		$99.13	$126.24	$377.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.01 / $191.11 / $217.18	Professional		$115.01	$191.11	$217.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $103.71 / $329.21	Facility		$99.13	$103.71	$329.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.71 / $103.71 / $372.90	Facility		$103.71	$103.71	$372.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.71 / $115.45 / $152.56	Professional		$103.71	$115.45	$152.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $99.13 / $112.90	Professional		$65.00	$99.13	$112.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $103.71 / $329.21	Facility		$99.13	$103.71	$329.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $155.22 / $425.70	Professional		$99.13	$155.22	$425.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $99.13 / $1,345.20	Facility		$99.13	$99.13	$1,345.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $99.13 / $99.13	Professional		$99.13	$99.13	$99.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $139.18 / $139.18 / $447.94	Professional		$139.18	$139.18	$447.94
United Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $110.35 / $145.83	Professional		$99.13	$110.35	$145.83