Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $209.77 / $262.22 / $389.83	Facility		$209.77	$262.22	$389.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.60 / $166.07 / $240.06	Professional		$134.60	$166.07	$240.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $375.84 / $454.51 / $480.73	Facility		$375.84	$454.51	$480.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.92 / $174.81 / $748.75	Professional		$69.92	$174.81	$748.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $427.22 / $427.22 / $444.02	Facility		$427.22	$427.22	$444.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $481.20 / $562.32 / $862.61	Facility		$481.20	$562.32	$862.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.72 / $470.72 / $534.91	Professional		$200.72	$470.72	$534.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $134.60 / $209.77 / $611.84	Facility		$134.60	$209.77	$611.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $157.33 / $209.77 / $611.84	Facility		$157.33	$209.77	$611.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $104.89 / $539.09	Professional		$87.41	$104.89	$539.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $482.48	Professional		$50.00	$85.00	$482.48
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $134.60 / $209.77 / $611.84	Facility		$134.60	$209.77	$611.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $332.67 / $425.95 / $584.16	Professional		$332.67	$425.95	$584.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $349.62 / $830.35 / $830.35	Facility		$349.62	$830.35	$830.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $161.44 / $874.05 / $874.05	Professional		$161.44	$874.05	$874.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $372.27 / $372.27 / $372.27	Professional		$372.27	$372.27	$372.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $508.04 / $954.46 / $954.46	Professional		$508.04	$954.46	$954.46
United Facility/Professional Facility Modifier Low / Median / High Price $139.85 / $139.85 / $379.34	Facility		$139.85	$139.85	$379.34
United Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $104.89 / $325.39	Professional		$78.66	$104.89	$325.39