Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.24 / $244.16 / $244.16	Facility		$164.24	$244.16	$244.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.31 / $89.78 / $704.02	Professional		$84.31	$89.78	$704.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.40 / $284.67 / $301.10	Facility		$235.40	$284.67	$301.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.80 / $43.80 / $446.64	Professional		$43.80	$43.80	$446.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.88 / $267.58 / $278.10	Facility		$85.88	$267.58	$278.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.97 / $351.71 / $539.54	Facility		$300.97	$351.71	$539.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.55 / $294.83 / $335.04	Professional		$125.55	$294.83	$335.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $54.75 / $98.54 / $200.37	Facility		$54.75	$98.54	$200.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.75 / $109.49 / $520.08	Facility		$54.75	$109.49	$520.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.50 / $109.49 / $241.58	Professional		$63.50	$109.49	$241.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $85.00 / $164.24	Professional		$54.75	$85.00	$164.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $54.75 / $98.54 / $200.37	Facility		$54.75	$98.54	$200.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.44 / $260.70 / $365.65	Professional		$128.44	$260.70	$365.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $218.98 / $218.98 / $520.08	Facility		$218.98	$218.98	$520.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $53.46 / $53.46	Professional		$52.91	$53.46	$53.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.63 / $82.63 / $233.16	Professional		$82.63	$82.63	$233.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.63 / $320.18 / $597.82	Professional		$82.63	$320.18	$597.82
United Facility/Professional Professional Modifier Low / Median / High Price $57.52 / $87.59 / $241.58	Professional		$57.52	$87.59	$241.58