Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.39 / $136.74 / $203.29	Facility		$109.39	$136.74	$203.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.75 / $86.60 / $358.36	Professional		$74.75	$86.60	$358.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $195.99 / $237.02 / $250.69	Facility		$195.99	$237.02	$250.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.02 / $55.60 / $377.18	Professional		$45.02	$55.60	$377.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.81 / $247.55 / $257.27	Facility		$60.81	$247.55	$257.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.51 / $292.74 / $449.07	Facility		$250.51	$292.74	$449.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.90 / $245.48 / $278.95	Professional		$104.90	$245.48	$278.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $69.34 / $72.93 / $109.39	Facility		$69.34	$72.93	$109.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.34 / $75.70 / $433.01	Facility		$69.34	$75.70	$433.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $91.16 / $252.51	Professional		$53.49	$91.16	$252.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.58 / $77.70 / $178.72	Professional		$45.58	$77.70	$178.72
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $69.34 / $72.93 / $109.39	Facility		$69.34	$72.93	$109.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $111.42 / $223.34 / $310.20	Professional		$111.42	$223.34	$310.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $182.32 / $182.32 / $433.01	Facility		$182.32	$182.32	$433.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.31 / $58.96 / $99.32	Professional		$48.31	$58.96	$99.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.79 / $93.79 / $194.13	Professional		$93.79	$93.79	$194.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.79 / $308.91 / $497.73	Professional		$93.79	$308.91	$497.73
United Facility/Professional Professional Modifier Low / Median / High Price $52.87 / $75.18 / $267.45	Professional		$52.87	$75.18	$267.45