Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.75 / $178.75 / $178.75	Facility		$178.75	$178.75	$178.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.70 / $158.99 / $178.75	Professional		$114.70	$158.99	$178.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $427.29 / $516.72 / $546.54	Facility		$427.29	$516.72	$546.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.77 / $45.77 / $607.65	Professional		$45.77	$45.77	$607.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.20 / $404.52 / $404.52	Facility		$302.20	$404.52	$404.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $410.01 / $544.46 / $735.00	Facility		$410.01	$544.46	$735.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.24 / $535.16 / $608.15	Professional		$235.24	$535.16	$608.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $114.70 / $238.49 / $695.59	Facility		$114.70	$238.49	$695.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.06 / $238.49 / $695.59	Facility		$134.06	$238.49	$695.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.76 / $106.38 / $510.44	Professional		$82.76	$106.38	$510.44
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 $114.70 / $238.49 / $695.59	Facility		$114.70	$238.49	$695.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $314.19 / $472.78 / $664.23	Professional		$314.19	$472.78	$664.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $397.48 / $944.02 / $944.02	Facility		$397.48	$944.02	$944.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $794.96 / $794.96 / $989.73	Professional		$794.96	$794.96	$989.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $317.22 / $317.22 / $317.22	Professional		$317.22	$317.22	$317.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $577.54 / $813.32 / $813.32	Professional		$577.54	$813.32	$813.32
United Facility/Professional Professional Modifier Low / Median / High Price $83.47 / $99.31 / $347.59	Professional		$83.47	$99.31	$347.59