Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $250.70 / $313.38 / $465.89	Facility		$250.70	$313.38	$465.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.87 / $250.70 / $294.26	Professional		$160.87	$250.70	$294.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $449.18 / $543.19 / $574.53	Facility		$449.18	$543.19	$574.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.17 / $208.92 / $898.36	Professional		$103.17	$208.92	$898.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $589.61 / $614.58 / $614.58	Facility		$589.61	$614.58	$614.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $574.91 / $671.83 / $1,030.60	Facility		$574.91	$671.83	$1,030.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.95 / $562.58 / $639.29	Professional		$239.95	$562.58	$639.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $160.87 / $250.70 / $731.22	Facility		$160.87	$250.70	$731.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $188.03 / $250.70 / $731.22	Facility		$188.03	$250.70	$731.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.17 / $171.01 / $752.11	Professional		$121.17	$171.01	$752.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $208.92	Professional		$50.00	$70.00	$208.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $160.87 / $250.70 / $731.22	Facility		$160.87	$250.70	$731.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $419.90 / $544.17 / $710.60	Professional		$419.90	$544.17	$710.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $451.86 / $992.37 / $992.37	Facility		$451.86	$992.37	$992.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $302.93 / $1,044.59 / $1,044.59	Professional		$302.93	$1,044.59	$1,044.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $214.94 / $214.94 / $444.90	Professional		$214.94	$214.94	$444.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $214.94 / $707.93 / $1,140.70	Professional		$214.94	$707.93	$1,140.70
United Facility/Professional Facility Modifier Low / Median / High Price $250.70 / $250.70 / $250.70	Facility		$250.70	$250.70	$250.70
United Facility/Professional Professional Modifier Low / Median / High Price $119.71 / $167.14 / $505.02	Professional		$119.71	$167.14	$505.02