Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $180.00 / $267.60	Facility		$144.00	$180.00	$267.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.40 / $114.00 / $182.40	Professional		$92.40	$114.00	$182.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.00 / $312.00 / $330.00	Facility		$258.00	$312.00	$330.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $120.00 / $513.98	Professional		$48.00	$120.00	$513.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $293.27 / $293.27 / $304.80	Facility		$293.27	$293.27	$304.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.81 / $385.41 / $591.23	Facility		$329.81	$385.41	$591.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.94 / $323.14 / $367.20	Professional		$137.94	$323.14	$367.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $144.00 / $420.00	Facility		$92.40	$144.00	$420.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $144.00 / $420.00	Facility		$108.00	$144.00	$420.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $72.00 / $370.06	Professional		$60.00	$72.00	$370.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $120.00	Professional		$50.00	$70.00	$120.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $144.00 / $420.00	Facility		$92.40	$144.00	$420.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $227.94 / $292.64 / $401.35	Professional		$227.94	$292.64	$401.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $811.07 / $811.07 / $811.07	Facility		$811.07	$811.07	$811.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $174.00 / $600.00 / $600.00	Professional		$174.00	$600.00	$600.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $255.55 / $255.55 / $255.55	Professional		$255.55	$255.55	$255.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $348.75 / $655.20 / $655.20	Professional		$348.75	$655.20	$655.20
United Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $120.00	Facility		$120.00	$120.00	$120.00
United Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $72.00 / $252.00	Professional		$52.16	$72.00	$252.00