Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.00 / $598.26 / $704.68	Facility		$316.00	$598.26	$704.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.68 / $317.94 / $645.04	Professional		$308.68	$317.94	$645.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $385.85 / $571.05 / $688.36	Facility		$385.85	$571.05	$688.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.68 / $308.68 / $392.02	Professional		$308.68	$308.68	$392.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $456.85 / $493.89 / $565.78	Facility		$456.85	$493.89	$565.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $304.87 / $361.69 / $817.77	Facility		$304.87	$361.69	$817.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.87 / $438.10 / $497.84	Professional		$304.87	$438.10	$497.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $306.80 / $306.80 / $680.05	Facility		$306.80	$306.80	$680.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $460.20 / $617.36 / $617.36	Professional		$460.20	$617.36	$617.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $306.79 / $306.80 / $675.77	Facility		$306.79	$306.80	$675.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $306.80 / $306.80 / $617.36	Professional		$306.80	$306.80	$617.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $293.94	Professional		$65.00	$85.00	$293.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $306.80 / $306.80 / $680.05	Facility		$306.80	$306.80	$680.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $460.20 / $617.36 / $617.36	Professional		$460.20	$617.36	$617.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $308.68 / $390.69 / $999.90	Professional		$308.68	$390.69	$999.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,469.70 / $1,469.70 / $1,469.70	Facility		$1,469.70	$1,469.70	$1,469.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $308.68 / $308.68 / $308.68	Professional		$308.68	$308.68	$308.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $433.39 / $433.39 / $433.39	Professional		$433.39	$433.39	$433.39
United Facility/Professional Professional Modifier Low / Median / High Price $308.68 / $308.68 / $422.64	Professional		$308.68	$308.68	$422.64