Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.09 / $222.62 / $330.95	Facility		$178.09	$222.62	$330.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.70 / $140.99 / $583.44	Professional		$121.70	$140.99	$583.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $319.08 / $385.87 / $408.13	Facility		$319.08	$385.87	$408.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.29 / $90.53 / $614.04	Professional		$73.29	$90.53	$614.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.00 / $403.00 / $418.85	Facility		$99.00	$403.00	$418.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.21 / $477.02 / $731.76	Facility		$408.21	$477.02	$731.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.57 / $399.64 / $454.14	Professional		$170.57	$399.64	$454.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $133.57 / $135.38 / $178.09	Facility		$133.57	$135.38	$178.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $121.70 / $135.38 / $704.95	Facility		$121.70	$135.38	$704.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $148.41 / $411.10	Professional		$87.11	$148.41	$411.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $290.95	Professional		$55.00	$85.00	$290.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $133.57 / $135.38 / $178.09	Facility		$133.57	$135.38	$178.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.39 / $363.53 / $942.00	Professional		$181.39	$363.53	$942.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $296.82 / $296.82 / $704.95	Facility		$296.82	$296.82	$704.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $84.10 / $141.13	Professional		$78.66	$84.10	$141.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.69 / $152.69 / $316.05	Professional		$152.69	$152.69	$316.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.69 / $591.65 / $810.32	Professional		$152.69	$591.65	$810.32
United Facility/Professional Facility Modifier Low / Median / High Price $178.09 / $178.09 / $178.09	Facility		$178.09	$178.09	$178.09
United Facility/Professional Professional Modifier Low / Median / High Price $74.20 / $121.30 / $367.49	Professional		$74.20	$121.30	$367.49