Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $261.67 / $486.27 / $1,205.82	Facility		$261.67	$486.27	$1,205.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.45 / $243.50 / $486.27	Professional		$174.45	$243.50	$486.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $468.83 / $566.96 / $599.66	Facility		$468.83	$566.96	$599.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.40 / $218.06 / $937.66	Professional		$105.40	$218.06	$937.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $579.54 / $579.54 / $602.34	Facility		$579.54	$579.54	$602.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $600.15 / $701.32 / $1,075.83	Facility		$600.15	$701.32	$1,075.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.57 / $587.19 / $667.26	Professional		$250.57	$587.19	$667.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $167.91 / $261.67 / $763.21	Facility		$167.91	$261.67	$763.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $196.25 / $261.67 / $763.21	Facility		$196.25	$261.67	$763.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.22 / $176.02 / $785.02	Professional		$123.22	$176.02	$785.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $218.06	Professional		$50.00	$70.00	$218.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $167.91 / $261.67 / $763.21	Facility		$167.91	$261.67	$763.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $438.10 / $568.91 / $741.40	Professional		$438.10	$568.91	$741.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $436.12 / $1,035.79 / $1,035.79	Facility		$436.12	$1,035.79	$1,035.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $286.33 / $1,090.30 / $1,093.64	Professional		$286.33	$1,090.30	$1,093.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $219.58 / $219.58 / $464.37	Professional		$219.58	$219.58	$464.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $219.58 / $850.85 / $1,190.60	Professional		$219.58	$850.85	$1,190.60
United Facility/Professional Professional Modifier Low / Median / High Price $109.03 / $174.45 / $616.08	Professional		$109.03	$174.45	$616.08