Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $222.24 / $413.00 / $675.45	Facility		$222.24	$413.00	$675.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.60 / $174.09 / $254.33	Professional		$142.60	$174.09	$254.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.18 / $481.52 / $509.30	Facility		$398.18	$481.52	$509.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.08 / $74.08 / $793.25	Professional		$74.08	$74.08	$793.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $470.41 / $470.41 / $470.41	Facility		$470.41	$470.41	$470.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $510.03 / $596.02 / $914.30	Facility		$510.03	$596.02	$914.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.11 / $498.71 / $566.71	Professional		$213.11	$498.71	$566.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $142.60 / $222.24 / $648.20	Facility		$142.60	$222.24	$648.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $166.68 / $222.24 / $693.00	Facility		$166.68	$222.24	$693.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $92.60 / $118.58 / $693.00	Professional		$92.60	$118.58	$693.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $148.16	Professional		$50.00	$70.00	$148.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $142.60 / $222.24 / $648.20	Facility		$142.60	$222.24	$648.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $333.03 / $441.95 / $619.87	Professional		$333.03	$441.95	$619.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $370.40 / $879.70 / $879.70	Facility		$370.40	$879.70	$879.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $176.38 / $740.80 / $922.30	Professional		$176.38	$740.80	$922.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $394.39	Professional		$185.20	$185.20	$394.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $457.50 / $1,011.19	Professional		$185.20	$457.50	$1,011.19
United Facility/Professional Facility Modifier Low / Median / High Price $222.24 / $222.24 / $222.24	Facility		$222.24	$222.24	$222.24
United Facility/Professional Professional Modifier Low / Median / High Price $83.34 / $111.12 / $456.19	Professional		$83.34	$111.12	$456.19