Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.07 / $325.77 / $383.72	Facility		$172.07	$325.77	$383.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $175.59 / $1,124.66	Professional		$170.48	$175.59	$1,124.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.10 / $315.39 / $380.17	Facility		$213.10	$315.39	$380.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $216.50	Professional		$170.48	$170.48	$216.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $233.40 / $233.40 / $272.77	Facility		$233.40	$233.40	$272.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.48 / $217.13 / $1,387.01	Facility		$170.48	$217.13	$1,387.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $498.08 / $791.11 / $898.99	Professional		$498.08	$791.11	$898.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $160.81 / $167.06 / $367.30	Facility		$160.81	$167.06	$367.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $82.57 / $340.96 / $340.96	Professional		$82.57	$340.96	$340.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $160.81 / $167.06 / $367.30	Facility		$160.81	$167.06	$367.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.06 / $167.06 / $340.96	Professional		$167.06	$167.06	$340.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $488.85	Professional		$65.00	$85.00	$488.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $160.81 / $167.06 / $367.30	Facility		$160.81	$167.06	$367.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $82.57 / $340.96 / $340.96	Professional		$82.57	$340.96	$340.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $321.66 / $1,528.00	Professional		$170.48	$321.66	$1,528.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,444.25 / $2,444.25 / $2,444.25	Facility		$2,444.25	$2,444.25	$2,444.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $170.48	Professional		$170.48	$170.48	$170.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $239.35 / $239.35 / $632.21	Professional		$239.35	$239.35	$632.21
United Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $255.72	Professional		$170.48	$170.48	$255.72