Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.84 / $187.31 / $278.45	Facility		$149.84	$187.31	$278.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.15 / $149.84 / $354.35	Professional		$96.15	$149.84	$354.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $268.47 / $324.66 / $343.39	Facility		$268.47	$324.66	$343.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $124.87 / $534.84	Professional		$49.95	$124.87	$534.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $305.17 / $305.17 / $317.17	Facility		$305.17	$305.17	$317.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $343.33 / $401.20 / $615.46	Facility		$343.33	$401.20	$615.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $336.25 / $382.10	Professional		$143.31	$336.25	$382.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $96.15 / $149.84 / $437.05	Facility		$96.15	$149.84	$437.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.38 / $149.84 / $437.05	Facility		$112.38	$149.84	$437.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.44 / $75.44 / $449.53	Professional		$62.44	$75.44	$449.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $96.15 / $149.84 / $437.05	Facility		$96.15	$149.84	$437.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $238.89 / $304.48 / $417.57	Professional		$238.89	$304.48	$417.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $883.04 / $883.04 / $883.04	Facility		$883.04	$883.04	$883.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.93 / $624.35 / $624.35	Professional		$115.93	$624.35	$624.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.31 / $94.31 / $265.92	Professional		$94.31	$94.31	$265.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.31 / $310.62 / $681.79	Professional		$94.31	$310.62	$681.79
United Facility/Professional Facility Modifier Low / Median / High Price $124.87 / $124.87 / $124.87	Facility		$124.87	$124.87	$124.87
United Facility/Professional Professional Modifier Low / Median / High Price $62.44 / $74.92 / $262.23	Professional		$62.44	$74.92	$262.23