Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $317.20 / $396.51 / $589.48	Facility		$317.20	$396.51	$589.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.54 / $317.20 / $694.78	Professional		$203.54	$317.20	$694.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $568.33 / $687.28 / $726.94	Facility		$568.33	$687.28	$726.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.74 / $251.35 / $1,132.22	Professional		$105.74	$251.35	$1,132.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $699.86 / $699.86 / $737.51	Facility		$699.86	$699.86	$737.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $727.20 / $849.80 / $1,303.60	Facility		$727.20	$849.80	$1,303.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.26 / $771.24 / $879.66	Professional		$286.26	$771.24	$879.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $237.91 / $317.20 / $925.19	Facility		$237.91	$317.20	$925.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $237.91 / $317.20 / $925.19	Facility		$237.91	$317.20	$925.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $211.47 / $264.33 / $1,453.34	Professional		$211.47	$264.33	$1,453.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $364.39	Professional		$50.00	$70.00	$364.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $237.91 / $317.20 / $925.19	Facility		$237.91	$317.20	$925.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $531.04 / $689.63 / $927.79	Professional		$531.04	$689.63	$927.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $528.67 / $1,255.61 / $1,255.61	Facility		$528.67	$1,255.61	$1,255.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $227.54 / $1,321.70 / $1,453.34	Professional		$227.54	$1,321.70	$1,453.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.17 / $215.17 / $562.91	Professional		$215.17	$215.17	$562.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.17 / $644.69 / $1,443.30	Professional		$215.17	$644.69	$1,443.30
United Facility/Professional Facility Modifier Low / Median / High Price $264.33 / $264.33 / $264.33	Facility		$264.33	$264.33	$264.33
United Facility/Professional Professional Modifier Low / Median / High Price $158.60 / $264.33 / $746.73	Professional		$158.60	$264.33	$746.73