Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.99 / $109.99 / $204.40	Facility		$109.99	$109.99	$204.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.58 / $86.16 / $109.99	Professional		$70.58	$86.16	$109.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $197.07 / $238.32 / $252.07	Facility		$197.07	$238.32	$252.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.27 / $77.91 / $392.60	Professional		$45.27	$77.91	$392.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $139.28 / $248.91 / $248.91	Facility		$139.28	$248.91	$248.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $252.31 / $294.85 / $452.31	Facility		$252.31	$294.85	$452.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $246.82 / $280.48	Professional		$108.47	$246.82	$280.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.58 / $109.99 / $320.81	Facility		$70.58	$109.99	$320.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.49 / $109.99 / $320.81	Facility		$82.49	$109.99	$320.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.16 / $67.90 / $329.98	Professional		$53.16	$67.90	$329.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $70.58 / $109.99 / $320.81	Facility		$70.58	$109.99	$320.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $152.82 / $218.28 / $306.14	Professional		$152.82	$218.28	$306.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $183.32 / $435.39 / $435.39	Facility		$183.32	$435.39	$435.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $366.64 / $458.30 / $458.30	Professional		$366.64	$458.30	$458.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $195.19 / $195.19 / $195.19	Professional		$195.19	$195.19	$195.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $266.38 / $500.46 / $500.46	Professional		$266.38	$500.46	$500.46
United Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $67.90 / $237.66	Professional		$47.53	$67.90	$237.66