Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.14 / $135.28 / $271.63	Facility		$58.14	$135.28	$271.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.64 / $105.81 / $333.70	Professional		$64.64	$105.81	$333.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.76 / $145.35 / $251.20	Professional		$81.76	$145.35	$251.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.58 / $87.58 / $102.90	Facility		$68.58	$87.58	$102.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $115.20 / $159.54	Professional		$96.00	$115.20	$159.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $280.25 / $327.49 / $435.26	Facility		$280.25	$327.49	$435.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.87 / $180.65 / $295.74	Professional		$86.87	$180.65	$295.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.45 / $94.00 / $186.28	Facility		$57.45	$94.00	$186.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.37 / $93.25 / $186.28	Facility		$60.37	$93.25	$186.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.94 / $211.89 / $657.47	Professional		$104.94	$211.89	$657.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.79 / $223.68 / $275.78	Professional		$56.79	$223.68	$275.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.59 / $94.81 / $186.28	Facility		$57.59	$94.81	$186.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.43 / $217.00 / $314.16	Professional		$135.43	$217.00	$314.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $97.37 / $138.80 / $328.49	Facility		$97.37	$138.80	$328.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $449.91 / $657.47	Professional		$114.82	$449.91	$657.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.19 / $112.19 / $157.44	Professional		$112.19	$112.19	$157.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.19 / $213.71 / $307.87	Professional		$112.19	$213.71	$307.87
United Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $166.68 / $279.33	Professional		$90.00	$166.68	$279.33