Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.62 / $143.28 / $213.01	Facility		$114.62	$143.28	$213.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.33 / $90.74 / $317.43	Professional		$78.33	$90.74	$317.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $205.37 / $248.35 / $262.68	Facility		$205.37	$248.35	$262.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $39.86 / $389.64	Professional		$39.86	$39.86	$389.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.95 / $233.44 / $242.62	Facility		$74.95	$233.44	$242.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.13 / $307.48 / $471.69	Facility		$263.13	$307.48	$471.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.86 / $257.20 / $292.29	Professional		$109.86	$257.20	$292.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.76 / $47.76 / $114.62	Facility		$47.76	$47.76	$114.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.76 / $78.33 / $453.72	Facility		$47.76	$78.33	$453.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.50 / $95.52 / $233.08	Professional		$55.50	$95.52	$233.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.28 / $65.00 / $143.28	Professional		$47.28	$65.00	$143.28
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $47.76 / $47.76 / $114.62	Facility		$47.76	$47.76	$114.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.10 / $232.70 / $324.50	Professional		$112.10	$232.70	$324.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $191.04 / $191.04 / $453.72	Facility		$191.04	$191.04	$453.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.63 / $50.63 / $53.24	Professional		$50.63	$50.63	$53.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $83.06 / $83.06 / $203.41	Professional		$83.06	$83.06	$203.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $83.06 / $321.86 / $521.54	Professional		$83.06	$321.86	$521.54
United Facility/Professional Facility Modifier Low / Median / High Price $47.76 / $76.42 / $95.52	Facility		$47.76	$76.42	$95.52
United Facility/Professional Professional Modifier Low / Median / High Price $51.58 / $66.59 / $233.08	Professional		$51.58	$66.59	$233.08