Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.40 / $205.50 / $305.51	Facility		$164.40	$205.50	$305.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $140.43 / $326.58	Professional		$45.00	$140.43	$326.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.55 / $356.20 / $376.75	Facility		$294.55	$356.20	$376.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.80 / $137.00 / $586.79	Professional		$54.80	$137.00	$586.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $137.00 / $203.48 / $362.72	Facility		$137.00	$203.48	$362.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $143.85 / $177.33	Professional		$137.00	$143.85	$177.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $376.67 / $440.17 / $675.23	Facility		$376.67	$440.17	$675.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.77 / $368.92 / $419.23	Professional		$157.77	$368.92	$419.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $105.49 / $164.40 / $479.50	Facility		$105.49	$164.40	$479.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.30 / $164.40 / $479.50	Facility		$123.30	$164.40	$479.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.50 / $82.20 / $422.49	Professional		$68.50	$82.20	$422.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $68.50 / $85.00	Professional		$50.00	$68.50	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $105.49 / $164.40 / $479.50	Facility		$105.49	$164.40	$479.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $260.79 / $334.45 / $458.68	Professional		$260.79	$334.45	$458.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $385.41 / $650.75 / $650.75	Facility		$385.41	$650.75	$650.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $198.65 / $685.00 / $685.00	Professional		$198.65	$685.00	$685.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $291.75 / $291.75 / $291.75	Professional		$291.75	$291.75	$291.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $398.15 / $748.02 / $748.02	Professional		$398.15	$748.02	$748.02
United Facility/Professional Professional Modifier Low / Median / High Price $59.55 / $82.20 / $287.70	Professional		$59.55	$82.20	$287.70