Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.99 / $204.40 / $720.10	Facility		$109.99	$204.40	$720.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.33 / $96.36 / $288.22	Professional		$62.33	$96.36	$288.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $197.07 / $238.32 / $252.07	Facility		$197.07	$238.32	$252.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.27 / $91.66 / $394.14	Professional		$45.27	$91.66	$394.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.66 / $248.91 / $258.70	Facility		$91.66	$248.91	$258.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.74 / $123.74 / $123.74	Professional		$123.74	$123.74	$123.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $252.31 / $294.85 / $452.31	Facility		$252.31	$294.85	$452.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.32 / $246.82 / $280.48	Professional		$105.32	$246.82	$280.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.58 / $109.99 / $320.81	Facility		$70.58	$109.99	$320.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.49 / $123.74 / $579.91	Facility		$82.49	$123.74	$579.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.82 / $75.04 / $458.30	Professional		$54.82	$75.04	$458.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $91.66	Professional		$50.00	$70.00	$91.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $70.58 / $109.99 / $320.81	Facility		$70.58	$109.99	$320.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $183.95 / $238.88 / $311.30	Professional		$183.95	$238.88	$311.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $198.25 / $435.39 / $435.39	Facility		$198.25	$435.39	$435.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $132.91 / $458.30 / $458.30	Professional		$132.91	$458.30	$458.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.31 / $94.31 / $195.19	Professional		$94.31	$94.31	$195.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.31 / $94.31 / $500.46	Professional		$94.31	$94.31	$500.46
United Facility/Professional Professional Modifier Low / Median / High Price $52.53 / $73.33 / $221.59	Professional		$52.53	$73.33	$221.59