Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.66 / $183.33 / $272.55	Facility		$146.66	$183.33	$272.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.11 / $116.11 / $229.35	Professional		$94.11	$116.11	$229.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $262.77 / $317.77 / $336.11	Facility		$262.77	$317.77	$336.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.36 / $122.22 / $523.48	Professional		$60.36	$122.22	$523.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $344.93 / $359.54 / $359.54	Facility		$344.93	$359.54	$359.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $336.12 / $392.78 / $602.53	Facility		$336.12	$392.78	$602.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.41 / $329.11 / $373.99	Professional		$140.41	$329.11	$373.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $94.11 / $146.66 / $427.77	Facility		$94.11	$146.66	$427.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $146.66 / $427.77	Facility		$110.00	$146.66	$427.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.89 / $90.53 / $439.99	Professional		$70.89	$90.53	$439.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $120.71	Professional		$50.00	$70.00	$120.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $94.11 / $146.66 / $427.77	Facility		$94.11	$146.66	$427.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $245.70 / $298.17 / $415.80	Professional		$245.70	$298.17	$415.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $244.44 / $580.54 / $580.54	Facility		$244.44	$580.54	$580.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.18 / $611.10 / $611.10	Professional		$139.18	$611.10	$611.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $260.27 / $260.27 / $260.27	Professional		$260.27	$260.27	$260.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $355.20 / $667.32 / $667.32	Professional		$355.20	$667.32	$667.32
United Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $122.22 / $122.22	Facility		$122.22	$122.22	$122.22
United Facility/Professional Professional Modifier Low / Median / High Price $63.37 / $90.53 / $271.60	Professional		$63.37	$90.53	$271.60