Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.41 / $185.52 / $275.81	Facility		$148.41	$185.52	$275.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.23 / $117.50 / $169.84	Professional		$95.23	$117.50	$169.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $265.91 / $321.57 / $340.12	Facility		$265.91	$321.57	$340.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.08 / $123.68 / $531.82	Professional		$61.08	$123.68	$531.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $335.84 / $335.84 / $349.05	Facility		$335.84	$335.84	$349.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $340.62 / $398.05 / $610.61	Facility		$340.62	$398.05	$610.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.07 / $333.05 / $378.46	Professional		$142.07	$333.05	$378.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $95.23 / $148.41 / $432.88	Facility		$95.23	$148.41	$432.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $111.31 / $148.41 / $432.88	Facility		$111.31	$148.41	$432.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.73 / $101.24 / $445.25	Professional		$71.73	$101.24	$445.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $123.68	Professional		$50.00	$70.00	$123.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $95.23 / $148.41 / $432.88	Facility		$95.23	$148.41	$432.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $248.30 / $322.39 / $420.20	Professional		$248.30	$322.39	$420.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $330.26 / $587.48 / $587.48	Facility		$330.26	$587.48	$587.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $179.34 / $618.40 / $618.40	Professional		$179.34	$618.40	$618.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.25 / $127.25 / $263.38	Professional		$127.25	$127.25	$263.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.25 / $359.44 / $675.29	Professional		$127.25	$359.44	$675.29
United Facility/Professional Facility Modifier Low / Median / High Price $148.41 / $148.41 / $148.41	Facility		$148.41	$148.41	$148.41
United Facility/Professional Professional Modifier Low / Median / High Price $70.87 / $98.94 / $298.97	Professional		$70.87	$98.94	$298.97