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 / $462.30	Professional		$159.63	$196.94	$462.30
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 $124.39 / $258.19 / $905.92	Professional		$124.39	$258.19	$905.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $572.17	Professional		$50.00	$85.00	$572.17
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 / $541.07 / $824.14	Professional		$416.65	$541.07	$824.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $414.62 / $984.72 / $984.72	Facility		$414.62	$984.72	$984.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $523.15 / $1,036.55 / $1,488.30	Professional		$523.15	$1,036.55	$1,488.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.32 / $325.32 / $441.48	Professional		$325.32	$325.32	$441.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.32 / $602.49 / $1,260.59	Professional		$325.32	$602.49	$1,260.59
United Facility/Professional Professional Modifier Low / Median / High Price $123.97 / $207.31 / $746.32	Professional		$123.97	$207.31	$746.32