Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $339.46 / $339.46 / $630.82	Facility		$339.46	$339.46	$630.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.82 / $268.74 / $429.98	Professional		$217.82	$268.74	$429.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $608.19 / $735.49 / $777.92	Facility		$608.19	$735.49	$777.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.15 / $113.15 / $1,211.63	Professional		$113.15	$113.15	$1,211.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $691.33 / $691.33 / $718.52	Facility		$691.33	$691.33	$718.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $778.57 / $909.82 / $1,395.68	Facility		$778.57	$909.82	$1,395.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.44 / $761.74 / $865.61	Professional		$325.44	$761.74	$865.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $217.82 / $339.46 / $990.08	Facility		$217.82	$339.46	$990.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $254.59 / $339.46 / $990.08	Facility		$254.59	$339.46	$990.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.44 / $169.73 / $872.36	Professional		$141.44	$169.73	$872.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $226.30	Professional		$50.00	$70.00	$226.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $217.82 / $339.46 / $990.08	Facility		$217.82	$339.46	$990.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $508.55 / $674.89 / $946.58	Professional		$508.55	$674.89	$946.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $565.76 / $1,343.68 / $1,343.68	Facility		$565.76	$1,343.68	$1,343.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $260.76 / $1,414.40 / $1,414.40	Professional		$260.76	$1,414.40	$1,414.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $602.41	Professional		$282.88	$282.88	$602.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $822.05 / $1,544.52	Professional		$282.88	$822.05	$1,544.52
United Facility/Professional Professional Modifier Low / Median / High Price $118.81 / $169.73 / $526.54	Professional		$118.81	$169.73	$526.54