Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.66 / $326.04 / $386.28	Facility		$119.66	$326.04	$386.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.72 / $119.66 / $135.97	Professional		$75.72	$119.66	$135.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.87 / $132.87 / $175.73	Professional		$132.87	$132.87	$175.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.87 / $142.87 / $305.74	Facility		$142.87	$142.87	$305.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $142.87 / $142.87 / $142.87	Professional		$142.87	$142.87	$142.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $383.88 / $448.59 / $509.76	Facility		$383.88	$448.59	$509.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.29 / $207.19 / $270.39	Professional		$58.29	$207.19	$270.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $117.73 / $119.66 / $142.87	Facility		$117.73	$119.66	$142.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.73 / $135.97 / $177.14	Facility		$117.73	$135.97	$177.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.49 / $71.27 / $133.12	Professional		$50.49	$71.27	$133.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $117.73 / $119.66 / $142.87	Facility		$117.73	$119.66	$142.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.75 / $214.31 / $365.18	Professional		$138.75	$214.31	$365.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $290.02 / $290.02 / $668.63	Facility		$290.02	$290.02	$668.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.29 / $627.84 / $878.22	Professional		$58.29	$627.84	$878.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.87 / $142.87 / $142.87	Professional		$142.87	$142.87	$142.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.87 / $142.87 / $142.87	Professional		$142.87	$142.87	$142.87
United Facility/Professional Professional Modifier Low / Median / High Price $47.44 / $71.27 / $113.79	Professional		$47.44	$71.27	$113.79