Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.00 / $303.20 / $404.27	Facility		$138.00	$303.20	$404.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $123.00 / $478.00	Professional		$77.00	$123.00	$478.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $215.00 / $260.00 / $275.00	Facility		$215.00	$260.00	$275.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $407.93	Professional		$40.00	$40.00	$407.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.05 / $244.39 / $254.00	Facility		$71.05	$244.39	$254.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $274.83 / $321.17 / $492.69	Facility		$274.83	$321.17	$492.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.81 / $269.27 / $306.00	Professional		$114.81	$269.27	$306.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.87 / $41.87 / $120.00	Facility		$41.87	$41.87	$120.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.87 / $100.00 / $474.38	Facility		$41.87	$100.00	$474.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.33 / $95.80 / $183.16	Professional		$52.33	$95.80	$183.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $150.00	Professional		$50.00	$85.00	$150.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $41.87 / $41.87 / $120.00	Facility		$41.87	$41.87	$120.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.42 / $238.33 / $334.28	Professional		$117.42	$238.33	$334.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $475.00	Facility		$200.00	$200.00	$475.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.74 / $41.74 / $49.48	Professional		$41.74	$41.74	$49.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $77.09 / $212.95	Professional		$77.09	$77.09	$212.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $298.73 / $546.00	Professional		$77.09	$298.73	$546.00
United Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $80.00 / $186.14	Professional		$50.00	$80.00	$186.14