Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.19 / $194.00 / $288.41	Facility		$155.19	$194.00	$288.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.05 / $122.86 / $308.57	Professional		$106.05	$122.86	$308.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $278.06 / $336.26 / $355.66	Facility		$278.06	$336.26	$355.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.73 / $78.89 / $527.57	Professional		$51.73	$78.89	$527.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $82.15 / $316.07 / $328.50	Facility		$82.15	$316.07	$328.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $355.94 / $415.95 / $638.07	Facility		$355.94	$415.95	$638.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.68 / $348.26 / $395.75	Professional		$148.68	$348.26	$395.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $68.90 / $74.48 / $155.19	Facility		$68.90	$74.48	$155.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.90 / $106.05 / $614.32	Facility		$68.90	$106.05	$614.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.08 / $103.46 / $232.79	Professional		$64.08	$103.46	$232.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $194.00	Professional		$55.00	$85.00	$194.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $68.90 / $74.48 / $155.19	Facility		$68.90	$74.48	$155.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $152.00 / $308.52 / $432.72	Professional		$152.00	$308.52	$432.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $258.66 / $258.66 / $614.32	Facility		$258.66	$258.66	$614.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.54 / $52.12 / $85.73	Professional		$46.54	$52.12	$85.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $80.75 / $275.41	Professional		$80.75	$80.75	$275.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $372.14 / $706.14	Professional		$80.75	$372.14	$706.14
United Facility/Professional Facility Modifier Low / Median / High Price $129.33 / $129.33 / $129.33	Facility		$129.33	$129.33	$129.33
United Facility/Professional Professional Modifier Low / Median / High Price $64.08 / $103.46 / $232.79	Professional		$64.08	$103.46	$232.79