Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.99 / $464.41 / $540.16	Facility		$257.99	$464.41	$540.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.50 / $288.00 / $498.84	Professional		$227.50	$288.00	$498.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $477.28 / $554.67 / $575.32	Facility		$477.28	$554.67	$575.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.19 / $232.19 / $314.74	Professional		$232.19	$232.19	$314.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $412.78 / $539.20 / $539.20	Facility		$412.78	$539.20	$539.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.60 / $626.34 / $895.32	Facility		$253.60	$626.34	$895.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.88 / $567.35 / $644.71	Professional		$262.88	$567.35	$644.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $257.99 / $257.99 / $568.85	Facility		$257.99	$257.99	$568.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $515.98 / $515.98 / $515.98	Professional		$515.98	$515.98	$515.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $248.23 / $257.99 / $568.85	Facility		$248.23	$257.99	$568.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.99 / $271.57 / $515.98	Professional		$257.99	$271.57	$515.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $629.50	Professional		$65.00	$85.00	$629.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $257.99 / $257.99 / $568.85	Facility		$257.99	$257.99	$568.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $515.98 / $515.98 / $515.98	Professional		$515.98	$515.98	$515.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.99 / $608.63 / $877.80	Professional		$257.99	$608.63	$877.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,018.39 / $1,018.39 / $1,018.39	Facility		$1,018.39	$1,018.39	$1,018.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $253.60 / $253.60 / $253.60	Professional		$253.60	$253.60	$253.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $306.08 / $362.22 / $362.22	Professional		$306.08	$362.22	$362.22
United Facility/Professional Professional Modifier Low / Median / High Price $257.99 / $271.57 / $412.78	Professional		$257.99	$271.57	$412.78