Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.98 / $172.37 / $255.29	Facility		$64.98	$172.37	$255.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $105.37 / $305.33	Professional		$59.50	$105.37	$305.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.04 / $133.37 / $235.16	Professional		$75.04	$133.37	$235.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.57 / $79.98 / $93.90	Facility		$62.57	$79.98	$93.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.15 / $108.18 / $149.63	Professional		$90.15	$108.18	$149.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.13 / $307.48 / $408.67	Facility		$263.13	$307.48	$408.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.65 / $164.96 / $277.89	Professional		$78.65	$164.96	$277.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $52.51 / $87.48 / $169.80	Facility		$52.51	$87.48	$169.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.19 / $87.20 / $170.30	Facility		$55.19	$87.20	$170.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.65 / $198.77 / $618.82	Professional		$96.65	$198.77	$618.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.62 / $163.84 / $216.79	Professional		$52.62	$163.84	$216.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $52.64 / $88.01 / $170.30	Facility		$52.64	$88.01	$170.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.34 / $198.73 / $295.08	Professional		$124.34	$198.73	$295.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.85 / $126.74 / $299.75	Facility		$88.85	$126.74	$299.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $422.78 / $618.82	Professional		$104.62	$422.78	$618.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.63 / $102.63 / $147.88	Professional		$102.63	$102.63	$147.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.63 / $195.12 / $289.31	Professional		$102.63	$195.12	$289.31
United Facility/Professional Professional Modifier Low / Median / High Price $95.94 / $157.41 / $267.00	Professional		$95.94	$157.41	$267.00