Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $339.46 / $424.32 / $630.82	Facility		$339.46	$424.32	$630.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.68 / $268.74 / $388.47	Professional		$103.68	$268.74	$388.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $608.19 / $735.49 / $777.92	Facility		$608.19	$735.49	$777.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.15 / $282.88 / $1,211.63	Professional		$113.15	$282.88	$1,211.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $282.88 / $420.15 / $748.95	Facility		$282.88	$420.15	$748.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $297.02 / $365.96	Professional		$282.88	$297.02	$365.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $778.57 / $909.82 / $1,395.68	Facility		$778.57	$909.82	$1,395.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.44 / $761.74 / $865.61	Professional		$325.44	$761.74	$865.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $217.82 / $339.46 / $990.08	Facility		$217.82	$339.46	$990.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $254.59 / $339.46 / $990.08	Facility		$254.59	$339.46	$990.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.44 / $169.73 / $872.36	Professional		$141.44	$169.73	$872.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $141.44	Professional		$50.00	$70.00	$141.44
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $217.82 / $339.46 / $990.08	Facility		$217.82	$339.46	$990.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $538.02 / $690.20 / $946.58	Professional		$538.02	$690.20	$946.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,610.71 / $6,610.71 / $6,610.71	Facility		$6,610.71	$6,610.71	$6,610.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $410.18 / $1,414.40 / $1,414.40	Professional		$410.18	$1,414.40	$1,414.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $602.41	Professional		$282.88	$282.88	$602.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $1,544.52	Professional		$282.88	$282.88	$1,544.52
United Facility/Professional Professional Modifier Low / Median / High Price $118.81 / $169.73 / $783.58	Professional		$118.81	$169.73	$783.58