Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.40 / $528.69 / $905.18	Facility		$43.40	$528.69	$905.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.50 / $157.50 / $267.75	Professional		$97.50	$157.50	$267.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $196.88 / $426.00	Facility		$141.00	$196.88	$426.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $251.01 / $777.87	Professional		$121.34	$251.01	$777.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.69 / $100.85 / $154.34	Facility		$39.69	$100.85	$154.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $104.73 / $170.45	Professional		$42.58	$104.73	$170.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $216.70 / $246.25 / $323.30	Facility		$216.70	$246.25	$323.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.84 / $496.18 / $563.84	Professional		$137.84	$496.18	$563.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.39 / $152.19 / $250.71	Facility		$109.39	$152.19	$250.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $139.93 / $251.35	Facility		$45.00	$139.93	$251.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.72 / $329.48 / $810.58	Professional		$147.72	$329.48	$810.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $126.32 / $421.52	Professional		$55.00	$126.32	$421.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $109.39 / $142.56 / $245.86	Facility		$109.39	$142.56	$245.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $235.29 / $314.19 / $428.12	Professional		$235.29	$314.19	$428.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $299.75 / $570.73 / $570.73	Facility		$299.75	$570.73	$570.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $193.18 / $647.95 / $810.58	Professional		$193.18	$647.95	$810.58
Security Health Facility/Professional Facility Modifier Low / Median / High Price $285.58 / $376.29 / $421.28	Facility		$285.58	$376.29	$421.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.63 / $52.50 / $64.56	Professional		$44.63	$52.50	$64.56
United Facility/Professional Professional Modifier Low / Median / High Price $144.21 / $302.77 / $567.92	Professional		$144.21	$302.77	$567.92