Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.02 / $422.05 / $812.25	Facility		$164.02	$422.05	$812.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.71 / $149.76 / $662.56	Professional		$92.71	$149.76	$662.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.05 / $130.94 / $610.91	Professional		$57.05	$130.94	$610.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $171.16 / $362.28	Facility		$142.63	$171.16	$362.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $149.76 / $184.44	Professional		$142.63	$149.76	$184.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $311.25 / $409.54 / $557.95	Facility		$311.25	$409.54	$557.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.01 / $384.08 / $436.45	Professional		$160.01	$384.08	$436.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $156.88 / $499.21	Facility		$142.63	$156.88	$499.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $361.95 / $655.50	Facility		$142.63	$361.95	$655.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.57 / $150.69 / $466.53	Professional		$91.57	$150.69	$466.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $142.63	Professional		$50.00	$70.00	$142.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $156.88 / $499.21	Facility		$142.63	$156.88	$499.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.31 / $340.14 / $477.07	Professional		$256.31	$340.14	$477.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $285.26 / $677.49 / $677.49	Facility		$285.26	$677.49	$677.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $111.11 / $570.52 / $710.30	Professional		$111.11	$570.52	$710.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $303.74	Professional		$142.63	$142.63	$303.74
Security Health Facility/Professional Facility Modifier Low / Median / High Price $171.16 / $171.16 / $171.16	Facility		$171.16	$171.16	$171.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $778.76	Professional		$142.63	$142.63	$778.76
United Facility/Professional Professional Modifier Low / Median / High Price $90.42 / $144.62 / $322.16	Professional		$90.42	$144.62	$322.16