Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.88 / $303.60 / $451.35	Facility		$242.88	$303.60	$451.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.85 / $192.28 / $303.60	Professional		$155.85	$192.28	$303.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $435.16 / $526.24 / $556.60	Facility		$435.16	$526.24	$556.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.95 / $190.20 / $866.92	Professional		$80.95	$190.20	$866.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $494.64 / $494.64 / $514.10	Facility		$494.64	$494.64	$514.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $556.89 / $650.77 / $998.30	Facility		$556.89	$650.77	$998.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.52 / $545.03 / $619.35	Professional		$232.52	$545.03	$619.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $155.85 / $242.88 / $708.40	Facility		$155.85	$242.88	$708.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $182.16 / $242.88 / $708.40	Facility		$182.16	$242.88	$708.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.20 / $121.44 / $624.16	Professional		$95.20	$121.44	$624.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $202.40	Professional		$50.00	$70.00	$202.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $155.85 / $242.88 / $708.40	Facility		$155.85	$242.88	$708.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $364.15 / $493.79 / $677.21	Professional		$364.15	$493.79	$677.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $404.80 / $961.40 / $961.40	Facility		$404.80	$961.40	$961.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $293.48 / $1,012.00 / $1,012.00	Professional		$293.48	$1,012.00	$1,012.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $143.79 / $143.79 / $431.02	Professional		$143.79	$143.79	$431.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $143.79 / $143.79 / $1,105.09	Professional		$143.79	$143.79	$1,105.09
United Facility/Professional Facility Modifier Low / Median / High Price $202.40 / $202.40 / $202.40	Facility		$202.40	$202.40	$202.40
United Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $121.44 / $376.75	Professional		$87.98	$121.44	$376.75