Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.55 / $274.14 / $298.58	Professional		$131.55	$274.14	$298.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.79 / $393.80 / $1,068.14	Professional		$135.79	$393.80	$1,068.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.79 / $136.22 / $157.31	Facility		$104.79	$136.22	$157.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.11 / $131.09 / $143.26	Professional		$110.11	$131.09	$143.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $233.39 / $272.73 / $362.49	Facility		$233.39	$272.73	$362.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.95 / $144.52 / $164.23	Professional		$102.95	$144.52	$164.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.59 / $274.14 / $657.96	Facility		$102.59	$274.14	$657.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.59 / $274.14 / $1,317.85	Facility		$102.59	$274.14	$1,317.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $374.61 / $865.52 / $1,779.80	Professional		$374.61	$865.52	$1,779.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $1,258.84	Professional		$50.00	$65.00	$1,258.84
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $102.59 / $274.14 / $657.96	Facility		$102.59	$274.14	$657.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $291.85 / $355.61 / $509.88	Professional		$291.85	$355.61	$509.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $338.70 / $2,489.36 / $2,489.36	Facility		$338.70	$2,489.36	$2,489.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $609.66 / $1,779.80 / $1,779.80	Professional		$609.66	$1,779.80	$1,779.80
United Facility/Professional Professional Modifier Low / Median / High Price $328.31 / $750.32 / $1,559.99	Professional		$328.31	$750.32	$1,559.99