Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $244.20 / $305.25 / $453.81	Facility		$244.20	$305.25	$453.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.69 / $193.33 / $336.42	Professional		$156.69	$193.33	$336.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $437.53 / $529.10 / $559.63	Facility		$437.53	$529.10	$559.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.40 / $203.50 / $871.63	Professional		$81.40	$203.50	$871.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $497.34 / $497.34 / $516.89	Facility		$497.34	$497.34	$516.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $559.60 / $653.92 / $1,003.15	Facility		$559.60	$653.92	$1,003.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.76 / $547.99 / $622.71	Professional		$233.76	$547.99	$622.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $156.69 / $244.20 / $712.25	Facility		$156.69	$244.20	$712.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $183.15 / $244.20 / $712.25	Facility		$183.15	$244.20	$712.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.52 / $133.00 / $627.55	Professional		$109.52	$133.00	$627.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $561.66	Professional		$50.00	$85.00	$561.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $156.69 / $244.20 / $712.25	Facility		$156.69	$244.20	$712.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $408.85 / $496.16 / $680.45	Professional		$408.85	$496.16	$680.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $407.00 / $966.63 / $966.63	Facility		$407.00	$966.63	$966.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $295.08 / $1,017.50 / $1,017.50	Professional		$295.08	$1,017.50	$1,017.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $167.16 / $167.16 / $433.36	Professional		$167.16	$167.16	$433.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $167.16 / $591.41 / $1,111.10	Professional		$167.16	$591.41	$1,111.10
United Facility/Professional Facility Modifier Low / Median / High Price $203.50 / $203.50 / $203.50	Facility		$203.50	$203.50	$203.50
United Facility/Professional Professional Modifier Low / Median / High Price $93.10 / $133.72 / $539.70	Professional		$93.10	$133.72	$539.70