Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.57 / $186.96 / $277.95	Facility		$149.57	$186.96	$277.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.97 / $118.41 / $186.96	Professional		$95.97	$118.41	$186.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $267.98 / $324.06 / $342.76	Facility		$267.98	$324.06	$342.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.86 / $83.09 / $508.44	Professional		$49.86	$83.09	$508.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $304.61 / $304.61 / $316.58	Facility		$304.61	$304.61	$316.58
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 / $335.63 / $381.40	Professional		$143.31	$335.63	$381.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $95.97 / $149.57 / $436.24	Facility		$95.97	$149.57	$436.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.18 / $149.57 / $436.24	Facility		$112.18	$149.57	$436.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $74.78 / $384.37	Professional		$43.89	$74.78	$384.37
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 $95.97 / $149.57 / $436.24	Facility		$95.97	$149.57	$436.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.80 / $296.95 / $416.49	Professional		$158.80	$296.95	$416.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $249.28 / $592.04 / $592.04	Facility		$249.28	$592.04	$592.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.06 / $623.20 / $623.20	Professional		$77.06	$623.20	$623.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $62.75 / $265.43	Professional		$62.75	$62.75	$265.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $62.75 / $680.53	Professional		$62.75	$62.75	$680.53
United Facility/Professional Facility Modifier Low / Median / High Price $124.64 / $124.64 / $124.64	Facility		$124.64	$124.64	$124.64
United Facility/Professional Professional Modifier Low / Median / High Price $45.49 / $79.81 / $193.19	Professional		$45.49	$79.81	$193.19