Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.04 / $257.25 / $417.81	Facility		$173.04	$257.25	$417.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.29 / $257.25 / $741.77	Professional		$92.29	$257.25	$741.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $248.02 / $299.94 / $317.24	Facility		$248.02	$299.94	$317.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $79.59 / $496.05	Professional		$56.97	$79.59	$496.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.96 / $313.24 / $325.55	Facility		$87.96	$313.24	$325.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $317.19 / $370.67 / $568.61	Facility		$317.19	$370.67	$568.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.78 / $168.37 / $353.00	Professional		$124.78	$168.37	$353.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.74 / $115.36 / $230.72	Facility		$102.74	$115.36	$230.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.74 / $138.43 / $547.96	Facility		$102.74	$138.43	$547.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.98 / $99.13 / $415.30	Professional		$68.98	$99.13	$415.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $70.00 / $173.04	Professional		$55.00	$70.00	$173.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $102.74 / $115.36 / $230.72	Facility		$102.74	$115.36	$230.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.92 / $275.35 / $392.70	Professional		$60.92	$275.35	$392.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $230.72 / $230.72 / $547.96	Facility		$230.72	$230.72	$547.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.14 / $576.79 / $638.40	Professional		$61.14	$576.79	$638.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $221.45 / $221.45 / $245.66	Professional		$221.45	$221.45	$245.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $221.45 / $221.45 / $629.87	Professional		$221.45	$221.45	$629.87
United Facility/Professional Facility Modifier Low / Median / High Price $57.68 / $92.29 / $115.36	Facility		$57.68	$92.29	$115.36
United Facility/Professional Professional Modifier Low / Median / High Price $66.91 / $92.29 / $292.75	Professional		$66.91	$92.29	$292.75