Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $402.47 / $761.94 / $897.51	Facility		$402.47	$761.94	$897.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.06 / $403.82 / $853.12	Professional		$392.06	$403.82	$853.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $490.08 / $725.31 / $874.29	Facility		$490.08	$725.31	$874.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $392.06 / $392.06 / $497.91	Professional		$392.06	$392.06	$497.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $536.76 / $536.76 / $627.29	Facility		$536.76	$536.76	$627.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $392.06 / $929.24 / $1,328.29	Facility		$392.06	$929.24	$1,328.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.11 / $580.39 / $659.54	Professional		$390.11	$580.39	$659.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $91.89 / $390.74 / $392.06	Facility		$91.89	$390.74	$392.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $49.97 / $784.12 / $784.12	Professional		$49.97	$784.12	$784.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.89 / $390.74 / $390.74	Facility		$91.89	$390.74	$390.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $390.74 / $390.74 / $784.12	Professional		$390.74	$390.74	$784.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $382.89	Professional		$65.00	$85.00	$382.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $91.89 / $390.74 / $392.06	Facility		$91.89	$390.74	$392.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $49.97 / $784.12 / $784.12	Professional		$49.97	$784.12	$784.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $392.06 / $533.20 / $1,184.00	Professional		$392.06	$533.20	$1,184.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,914.45 / $1,914.45 / $1,914.45	Facility		$1,914.45	$1,914.45	$1,914.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $392.06 / $392.06 / $392.06	Professional		$392.06	$392.06	$392.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $386.13 / $550.45 / $569.39	Professional		$386.13	$550.45	$569.39
United Facility/Professional Professional Modifier Low / Median / High Price $392.06 / $392.06 / $536.80	Professional		$392.06	$392.06	$536.80