Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.18 / $687.44 / $1,148.04	Facility		$175.18	$687.44	$1,148.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.86 / $267.20 / $780.80	Professional		$81.86	$267.20	$780.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $101.23 / $336.35	Professional		$85.27	$101.23	$336.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.51 / $103.14 / $144.40	Facility		$97.51	$103.14	$144.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.98 / $350.21 / $552.46	Facility		$86.98	$350.21	$552.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $187.18 / $212.70	Professional		$86.98	$187.18	$212.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $81.86 / $102.33 / $130.01	Facility		$81.86	$102.33	$130.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.86 / $114.19 / $515.28	Facility		$81.86	$114.19	$515.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $85.27 / $179.07	Professional		$85.27	$85.27	$179.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $373.49	Professional		$55.00	$85.00	$373.49
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $81.86 / $102.33 / $248.82	Facility		$81.86	$102.33	$248.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $175.53 / $384.93 / $536.79	Professional		$175.53	$384.93	$536.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $717.30 / $717.30 / $717.30	Facility		$717.30	$717.30	$717.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $108.47 / $717.30	Professional		$86.98	$108.47	$717.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.94 / $147.94 / $147.94	Professional		$147.94	$147.94	$147.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $135.28 / $135.28 / $147.94	Professional		$135.28	$135.28	$147.94
United Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $85.27 / $116.75	Professional		$85.27	$85.27	$116.75