Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.70 / $265.88 / $395.27	Facility		$212.70	$265.88	$395.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $212.70 / $819.28	Professional		$136.47	$212.70	$819.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $381.09 / $460.85 / $487.44	Facility		$381.09	$460.85	$487.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.53 / $177.25 / $762.18	Professional		$87.53	$177.25	$762.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $481.30 / $481.30 / $500.23	Facility		$481.30	$481.30	$500.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $487.51 / $569.69 / $873.92	Facility		$487.51	$569.69	$873.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.61 / $477.30 / $542.39	Professional		$203.61	$477.30	$542.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $136.47 / $212.70 / $620.38	Facility		$136.47	$212.70	$620.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $159.53 / $212.70 / $620.38	Facility		$159.53	$212.70	$620.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.81 / $145.09 / $638.10	Professional		$102.81	$145.09	$638.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $489.21	Professional		$50.00	$70.00	$489.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $136.47 / $212.70 / $620.38	Facility		$136.47	$212.70	$620.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $356.20 / $462.04 / $602.79	Professional		$356.20	$462.04	$602.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $473.29 / $841.94 / $841.94	Facility		$473.29	$841.94	$841.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.01 / $886.25 / $886.25	Professional		$257.01	$886.25	$886.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $182.36 / $182.36 / $377.46	Professional		$182.36	$182.36	$377.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $182.36 / $182.36 / $967.79	Professional		$182.36	$182.36	$967.79
United Facility/Professional Facility Modifier Low / Median / High Price $177.25 / $177.25 / $177.25	Facility		$177.25	$177.25	$177.25
United Facility/Professional Professional Modifier Low / Median / High Price $101.56 / $145.09 / $507.80	Professional		$101.56	$145.09	$507.80