Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $296.30 / $296.30 / $296.30	Facility		$296.30	$296.30	$296.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.47 / $296.30 / $296.30	Professional		$202.47	$296.30	$296.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $530.88 / $641.99 / $679.03	Facility		$530.88	$641.99	$679.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.77 / $45.77 / $987.68	Professional		$45.77	$45.77	$987.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.88 / $246.92 / $375.54	Facility		$169.88	$246.92	$375.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $679.44 / $793.98 / $1,217.99	Facility		$679.44	$793.98	$1,217.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.73 / $664.91 / $755.58	Professional		$283.73	$664.91	$755.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $130.87 / $222.23 / $316.06	Facility		$130.87	$222.23	$316.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $130.87 / $246.92 / $1,172.86	Facility		$130.87	$246.92	$1,172.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.21 / $246.92 / $518.53	Professional		$143.21	$246.92	$518.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $123.46	Professional		$55.00	$65.00	$123.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $130.87 / $222.23 / $316.06	Facility		$130.87	$222.23	$316.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $289.94 / $588.50 / $839.30	Professional		$289.94	$588.50	$839.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $493.84 / $493.84 / $1,172.86	Facility		$493.84	$493.84	$1,172.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $130.87 / $130.87 / $130.87	Professional		$130.87	$130.87	$130.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $525.83 / $525.83 / $525.83	Professional		$525.83	$525.83	$525.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,296.33 / $1,348.18 / $1,348.18	Professional		$1,296.33	$1,348.18	$1,348.18
United Facility/Professional Professional Modifier Low / Median / High Price $123.46 / $197.54 / $518.53	Professional		$123.46	$197.54	$518.53