Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.52 / $312.49 / $6,129.38	Facility		$109.52	$312.49	$6,129.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $109.52 / $148.87	Professional		$106.33	$109.52	$148.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $196.71 / $228.61 / $237.12	Facility		$196.71	$228.61	$237.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $159.49	Professional		$106.33	$106.33	$159.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $157.37 / $204.06	Facility		$106.33	$157.37	$204.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $122.28 / $246.53	Professional		$106.33	$122.28	$246.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $191.86 / $398.85	Facility		$106.33	$191.86	$398.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $171.69 / $216.39	Professional		$106.33	$171.69	$216.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $110.59 / $153.33	Facility		$106.33	$110.59	$153.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $136.04 / $137.40 / $291.47	Facility		$136.04	$137.40	$291.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.04 / $151.44 / $1,358.07	Professional		$136.04	$151.44	$1,358.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $85.00 / $136.04	Professional		$58.40	$85.00	$136.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $110.59 / $153.33	Facility		$106.33	$110.59	$153.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $167.11 / $460.90	Professional		$106.33	$167.11	$460.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $354.88 / $1,433.35	Facility		$106.33	$354.88	$1,433.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $354.88 / $1,358.07	Professional		$106.33	$354.88	$1,358.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $149.29 / $149.29 / $149.29	Professional		$149.29	$149.29	$149.29
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $109.52 / $133.97	Professional		$106.33	$109.52	$133.97