Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.92 / $641.75 / $755.93	Facility		$338.92	$641.75	$755.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $338.92 / $565.39	Professional		$329.05	$338.92	$565.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $411.31 / $608.74 / $733.78	Facility		$411.31	$608.74	$733.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $417.89	Professional		$329.05	$329.05	$417.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $450.50 / $450.50 / $526.48	Facility		$450.50	$450.50	$526.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.05 / $419.06 / $884.43	Facility		$329.05	$419.06	$884.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $498.38 / $566.34	Professional		$329.05	$498.38	$566.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $329.05 / $329.10 / $724.96	Facility		$329.05	$329.10	$724.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $493.65 / $658.10 / $658.10	Professional		$493.65	$658.10	$658.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $329.10 / $329.10 / $724.96	Facility		$329.10	$329.10	$724.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $329.10 / $329.10 / $658.10	Professional		$329.10	$329.10	$658.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $777.99	Professional		$65.00	$85.00	$777.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $329.05 / $329.10 / $724.96	Facility		$329.05	$329.10	$724.96
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $493.65 / $658.10 / $658.10	Professional		$493.65	$658.10	$658.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $494.22 / $1,062.23	Professional		$329.05	$494.22	$1,062.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,594.25 / $1,594.25 / $1,594.25	Facility		$1,594.25	$1,594.25	$1,594.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $329.05	Professional		$329.05	$329.05	$329.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $461.99 / $461.99 / $461.99	Professional		$461.99	$461.99	$461.99
United Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $427.77	Professional		$329.05	$329.05	$427.77