Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.73 / $164.82 / $218.79	Facility		$117.73	$164.82	$218.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.23 / $92.22 / $253.22	Professional		$75.23	$92.22	$253.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.94 / $255.09 / $269.80	Facility		$210.94	$255.09	$269.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $39.24 / $400.22	Professional		$39.24	$39.24	$400.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.53 / $103.02 / $239.77	Facility		$63.53	$103.02	$239.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $270.33 / $315.91 / $484.61	Facility		$270.33	$315.91	$484.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.75 / $264.19 / $300.20	Professional		$112.75	$264.19	$300.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $49.06 / $49.06 / $117.73	Facility		$49.06	$49.06	$117.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.06 / $117.73 / $466.02	Facility		$49.06	$117.73	$466.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $88.36 / $190.34	Professional		$52.64	$88.36	$190.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.06 / $85.00 / $147.16	Professional		$49.06	$85.00	$147.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $49.06 / $49.06 / $117.73	Facility		$49.06	$49.06	$117.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.14 / $233.70 / $327.79	Professional		$115.14	$233.70	$327.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $196.22 / $196.22 / $466.02	Facility		$196.22	$196.22	$466.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.46 / $42.46 / $42.46	Professional		$42.46	$42.46	$42.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.27 / $66.27 / $208.93	Professional		$66.27	$66.27	$208.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.27 / $285.13 / $535.67	Professional		$66.27	$285.13	$535.67
United Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $85.36 / $182.62	Professional		$52.59	$85.36	$182.62