Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $369.60 / $462.00 / $686.84	Facility		$369.60	$462.00	$686.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.16 / $292.60 / $462.00	Professional		$237.16	$292.60	$462.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $662.20 / $800.80 / $847.00	Facility		$662.20	$800.80	$847.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.20 / $160.84 / $1,256.41	Professional		$123.20	$160.84	$1,256.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $752.72 / $752.72 / $782.32	Facility		$752.72	$752.72	$782.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $847.95 / $990.90 / $1,520.07	Facility		$847.95	$990.90	$1,520.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.94 / $829.38 / $942.48	Professional		$353.94	$829.38	$942.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $237.16 / $369.60 / $1,078.00	Facility		$237.16	$369.60	$1,078.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $277.20 / $369.60 / $1,078.00	Facility		$277.20	$369.60	$1,078.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.50 / $184.80 / $949.83	Professional		$96.50	$184.80	$949.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $154.00	Professional		$50.00	$70.00	$154.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $237.16 / $369.60 / $1,078.00	Facility		$237.16	$369.60	$1,078.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $308.02 / $734.28 / $1,029.86	Professional		$308.02	$734.28	$1,029.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $616.00 / $1,463.00 / $1,463.00	Facility		$616.00	$1,463.00	$1,463.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $446.60 / $1,540.00 / $1,540.00	Professional		$446.60	$1,540.00	$1,540.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.60 / $121.60 / $655.90	Professional		$121.60	$121.60	$655.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.60 / $471.18 / $1,681.68	Professional		$121.60	$471.18	$1,681.68
United Facility/Professional Professional Modifier Low / Median / High Price $96.74 / $184.80 / $477.40	Professional		$96.74	$184.80	$477.40