Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.40 / $225.50 / $335.24	Facility		$180.40	$225.50	$335.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.75 / $142.81 / $228.50	Professional		$115.75	$142.81	$228.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.20 / $390.86 / $413.41	Facility		$323.20	$390.86	$413.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.13 / $150.33 / $643.89	Professional		$60.13	$150.33	$643.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $381.84 / $398.01 / $398.01	Facility		$381.84	$398.01	$398.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $413.61 / $483.34 / $741.46	Facility		$413.61	$483.34	$741.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.05 / $404.81 / $460.01	Professional		$173.05	$404.81	$460.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $115.75 / $180.40 / $526.16	Facility		$115.75	$180.40	$526.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $135.30 / $180.40 / $526.16	Facility		$135.30	$180.40	$526.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $90.20 / $463.60	Professional		$75.17	$90.20	$463.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $115.75 / $180.40 / $526.16	Facility		$115.75	$180.40	$526.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $286.12 / $366.79 / $503.04	Professional		$286.12	$366.79	$503.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $883.04 / $883.04 / $883.04	Facility		$883.04	$883.04	$883.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $217.98 / $751.65 / $751.65	Professional		$217.98	$751.65	$751.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $320.13 / $320.13 / $320.13	Professional		$320.13	$320.13	$320.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $436.89 / $820.80 / $820.80	Professional		$436.89	$820.80	$820.80
United Facility/Professional Professional Modifier Low / Median / High Price $67.65 / $96.26 / $315.69	Professional		$67.65	$96.26	$315.69