Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.79 / $402.91 / $474.57	Facility		$212.79	$402.91	$474.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $212.79 / $457.16	Professional		$206.59	$212.79	$457.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.24 / $382.19 / $460.70	Facility		$258.24	$382.19	$460.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $206.59 / $262.36	Professional		$206.59	$206.59	$262.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $282.83 / $282.83 / $330.54	Facility		$282.83	$282.83	$330.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $206.59 / $242.06 / $561.87	Facility		$206.59	$242.06	$561.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $307.67 / $349.63	Professional		$206.59	$307.67	$349.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $152.68 / $206.62 / $455.50	Facility		$152.68	$206.62	$455.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $309.93 / $413.18 / $413.18	Professional		$309.93	$413.18	$413.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $152.68 / $206.62 / $455.50	Facility		$152.68	$206.62	$455.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $206.62 / $206.62 / $413.18	Professional		$206.62	$206.62	$413.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $201.57	Professional		$65.00	$85.00	$201.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $152.68 / $206.62 / $455.50	Facility		$152.68	$206.62	$455.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $309.93 / $413.18 / $413.18	Professional		$309.93	$413.18	$413.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $218.99 / $673.21	Professional		$206.59	$218.99	$673.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,007.85 / $1,007.85 / $1,007.85	Facility		$1,007.85	$1,007.85	$1,007.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $206.59 / $206.59	Professional		$206.59	$206.59	$206.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $207.75 / $290.05 / $299.83	Professional		$207.75	$290.05	$299.83
United Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $206.59 / $433.84	Professional		$206.59	$206.59	$433.84