Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.95 / $443.69 / $659.61	Facility		$354.95	$443.69	$659.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.47 / $278.04 / $354.95	Professional		$177.47	$278.04	$354.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.95 / $769.05 / $813.42	Facility		$635.95	$769.05	$813.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.32 / $295.79 / $1,266.93	Professional		$118.32	$295.79	$1,266.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $295.79 / $439.33 / $751.31	Facility		$295.79	$439.33	$751.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.79 / $310.58 / $382.28	Professional		$295.79	$310.58	$382.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $813.71 / $950.89 / $1,458.68	Facility		$813.71	$950.89	$1,458.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.90 / $796.50 / $905.11	Professional		$339.90	$796.50	$905.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $227.76 / $354.95 / $1,035.27	Facility		$227.76	$354.95	$1,035.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $266.20 / $354.95 / $1,035.27	Facility		$266.20	$354.95	$1,035.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $178.72 / $912.17	Professional		$147.90	$178.72	$912.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $175.10	Professional		$50.00	$70.00	$175.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $227.76 / $354.95 / $1,035.27	Facility		$227.76	$354.95	$1,035.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $565.40 / $720.96 / $988.77	Professional		$565.40	$720.96	$988.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $918.65 / $1,405.00 / $1,405.00	Facility		$918.65	$1,405.00	$1,405.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $274.38 / $1,478.95 / $1,478.95	Professional		$274.38	$1,478.95	$1,478.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $223.40 / $223.40 / $629.90	Professional		$223.40	$223.40	$629.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $223.40 / $865.64 / $1,615.01	Professional		$223.40	$865.64	$1,615.01
United Facility/Professional Professional Modifier Low / Median / High Price $128.58 / $177.47 / $550.58	Professional		$128.58	$177.47	$550.58