Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.09 / $135.09 / $396.12	Facility		$135.09	$135.09	$396.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.15 / $135.09 / $226.85	Professional		$131.15	$135.09	$226.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $242.65 / $281.99 / $292.49	Facility		$242.65	$281.99	$292.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $131.16 / $177.06	Professional		$131.16	$131.16	$177.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $194.12 / $209.86 / $240.40	Facility		$194.12	$209.86	$240.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.19 / $137.62 / $268.60	Facility		$129.19	$137.62	$268.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.28 / $110.55 / $170.95	Professional		$97.28	$110.55	$170.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $131.16 / $132.04 / $288.70	Facility		$131.16	$132.04	$288.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $132.04 / $132.04 / $671.84	Facility		$132.04	$132.04	$671.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.04 / $146.99 / $194.24	Professional		$132.04	$146.99	$194.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $131.16 / $134.25	Professional		$85.00	$131.16	$134.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $131.16 / $132.04 / $288.70	Facility		$131.16	$132.04	$288.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $195.48 / $532.54	Professional		$131.16	$195.48	$532.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $131.16 / $131.16 / $671.25	Facility		$131.16	$131.16	$671.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $131.16 / $131.16	Professional		$131.16	$131.16	$131.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $184.15 / $184.15 / $184.15	Professional		$184.15	$184.15	$184.15
United Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $146.01 / $192.94	Professional		$131.16	$146.01	$192.94