Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $248.77 / $310.97 / $462.30	Facility		$248.77	$310.97	$462.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.63 / $196.94 / $429.25	Professional		$159.63	$196.94	$429.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $445.72 / $539.01 / $570.10	Facility		$445.72	$539.01	$570.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.38 / $207.31 / $891.43	Professional		$102.38	$207.31	$891.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $562.95 / $562.95 / $585.09	Facility		$562.95	$562.95	$585.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $570.41 / $666.57 / $1,022.53	Facility		$570.41	$666.57	$1,022.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.30 / $558.24 / $634.36	Professional		$238.30	$558.24	$634.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $159.63 / $248.77 / $725.59	Facility		$159.63	$248.77	$725.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $186.58 / $248.77 / $725.59	Facility		$186.58	$248.77	$725.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.97 / $169.70 / $746.32	Professional		$123.97	$169.70	$746.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $207.31	Professional		$50.00	$70.00	$207.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $159.63 / $248.77 / $725.59	Facility		$159.63	$248.77	$725.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $416.65 / $540.07 / $705.10	Professional		$416.65	$540.07	$705.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $448.39 / $984.72 / $984.72	Facility		$448.39	$984.72	$984.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $300.60 / $1,036.55 / $1,036.55	Professional		$300.60	$1,036.55	$1,036.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $213.29 / $213.29 / $441.48	Professional		$213.29	$213.29	$441.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $213.29 / $702.50 / $1,131.91	Professional		$213.29	$702.50	$1,131.91
United Facility/Professional Facility Modifier Low / Median / High Price $184.28 / $184.28 / $499.86	Facility		$184.28	$184.28	$499.86
United Facility/Professional Professional Modifier Low / Median / High Price $118.79 / $165.85 / $593.94	Professional		$118.79	$165.85	$593.94