Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.44 / $370.01 / $435.83	Facility		$195.44	$370.01	$435.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.76 / $199.57 / $325.99	Professional		$193.76	$199.57	$325.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $242.20 / $358.46 / $432.08	Facility		$242.20	$358.46	$432.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.76 / $193.76 / $246.07	Professional		$193.76	$193.76	$246.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $265.27 / $265.27 / $310.02	Facility		$265.27	$265.27	$310.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $227.01 / $518.35	Facility		$193.25	$227.01	$518.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $279.38 / $317.48	Professional		$193.25	$279.38	$317.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $189.75 / $189.75 / $426.99	Facility		$189.75	$189.75	$426.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $284.63 / $387.52 / $387.52	Professional		$284.63	$387.52	$387.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $189.75 / $189.75 / $418.43	Facility		$189.75	$189.75	$418.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $189.75 / $189.75 / $387.52	Professional		$189.75	$189.75	$387.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $186.31	Professional		$85.00	$85.00	$186.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $189.75 / $189.75 / $426.99	Facility		$189.75	$189.75	$426.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $284.63 / $387.52 / $387.52	Professional		$284.63	$387.52	$387.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $193.76 / $288.77 / $622.42	Professional		$193.76	$288.77	$622.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $931.55 / $931.55 / $931.55	Facility		$931.55	$931.55	$931.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $193.76 / $193.76 / $193.76	Professional		$193.76	$193.76	$193.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $272.04 / $272.04 / $272.04	Professional		$272.04	$272.04	$272.04
United Facility/Professional Professional Modifier Low / Median / High Price $193.76 / $193.76 / $265.30	Professional		$193.76	$193.76	$265.30