Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $171.16 / $171.16 / $171.16	Facility		$171.16	$171.16	$171.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.83 / $134.07 / $171.16	Professional		$109.83	$134.07	$171.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $306.64 / $370.84 / $392.23	Facility		$306.64	$370.84	$392.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.92 / $5.92 / $581.83	Professional		$5.92	$5.92	$581.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $217.05 / $217.05 / $217.05	Facility		$217.05	$217.05	$217.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $392.89 / $459.12 / $704.30	Facility		$392.89	$459.12	$704.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.88 / $384.08 / $436.45	Professional		$168.88	$384.08	$436.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.83 / $171.16 / $499.21	Facility		$109.83	$171.16	$499.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.83 / $171.16 / $499.21	Facility		$109.83	$171.16	$499.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.31 / $85.58 / $439.85	Professional		$71.31	$85.58	$439.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $109.83 / $171.16 / $499.21	Facility		$109.83	$171.16	$499.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $238.14 / $340.14 / $477.07	Professional		$238.14	$340.14	$477.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $285.26 / $677.49 / $677.49	Facility		$285.26	$677.49	$677.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $570.52 / $713.15 / $713.15	Professional		$570.52	$713.15	$713.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $303.74 / $303.74 / $303.74	Professional		$303.74	$303.74	$303.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $414.51 / $778.76 / $778.76	Professional		$414.51	$778.76	$778.76
United Facility/Professional Professional Modifier Low / Median / High Price $64.18 / $85.58 / $265.49	Professional		$64.18	$85.58	$265.49