Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.48 / $210.48 / $391.14	Facility		$210.48	$210.48	$391.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.06 / $166.63 / $266.61	Professional		$135.06	$166.63	$266.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $377.11 / $456.04 / $482.35	Facility		$377.11	$456.04	$482.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.16 / $70.16 / $751.27	Professional		$70.16	$70.16	$751.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $445.52 / $464.39 / $464.39	Facility		$445.52	$464.39	$464.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $483.00 / $564.41 / $865.84	Facility		$483.00	$564.41	$865.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.54 / $472.32 / $536.73	Professional		$201.54	$472.32	$536.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $135.06 / $210.48 / $613.90	Facility		$135.06	$210.48	$613.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $157.86 / $210.48 / $613.90	Facility		$157.86	$210.48	$613.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.70 / $105.24 / $540.91	Professional		$87.70	$105.24	$540.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $175.40	Professional		$50.00	$65.00	$175.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $135.06 / $210.48 / $613.90	Facility		$135.06	$210.48	$613.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $315.01 / $418.04 / $586.34	Professional		$315.01	$418.04	$586.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $350.80 / $833.15 / $833.15	Facility		$350.80	$833.15	$833.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $161.77 / $877.00 / $877.00	Professional		$161.77	$877.00	$877.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $175.40 / $373.52	Professional		$175.40	$175.40	$373.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $574.02 / $957.68	Professional		$175.40	$574.02	$957.68
United Facility/Professional Facility Modifier Low / Median / High Price $175.40 / $175.40 / $175.40	Facility		$175.40	$175.40	$175.40
United Facility/Professional Professional Modifier Low / Median / High Price $76.25 / $105.24 / $368.34	Professional		$76.25	$105.24	$368.34