Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.71 / $833.60 / $1,209.59	Facility		$218.71	$833.60	$1,209.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.48 / $221.23 / $779.54	Professional		$102.48	$221.23	$779.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $248.83	Professional		$75.00	$75.00	$248.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.44 / $117.87 / $165.02	Facility		$111.44	$117.87	$165.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.99 / $386.05 / $609.00	Facility		$109.99	$386.05	$609.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $216.68 / $246.23	Professional		$109.99	$216.68	$246.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.48 / $123.84 / $189.52	Facility		$102.48	$123.84	$189.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.48 / $222.00 / $655.26	Facility		$102.48	$222.00	$655.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $450.58 / $450.58 / $739.96	Professional		$450.58	$450.58	$739.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $382.97	Professional		$55.00	$85.00	$382.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $102.48 / $123.84 / $273.16	Facility		$102.48	$123.84	$273.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.85 / $284.76 / $397.10	Professional		$129.85	$284.76	$397.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $638.99 / $638.99 / $638.99	Facility		$638.99	$638.99	$638.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $517.50 / $739.96	Professional		$109.99	$517.50	$739.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $160.44 / $160.44 / $160.44	Professional		$160.44	$160.44	$160.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $496.46 / $496.46	Professional		$153.00	$496.46	$496.46
United Facility/Professional Professional Modifier Low / Median / High Price $450.58 / $450.58 / $616.92	Professional		$450.58	$450.58	$616.92