Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $209.69 / $413.79 / $487.39	Facility		$209.69	$413.79	$487.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $218.56 / $11,231.55	Professional		$203.58	$218.56	$11,231.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $254.48 / $376.62 / $453.98	Facility		$254.48	$376.62	$453.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $203.58 / $258.54	Professional		$203.58	$203.58	$258.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $278.72 / $278.72 / $325.73	Facility		$278.72	$278.72	$325.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.58 / $287.57 / $597.80	Facility		$203.58	$287.57	$597.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.46 / $328.80 / $373.64	Professional		$208.46	$328.80	$373.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $116.51 / $203.58 / $212.20	Facility		$116.51	$203.58	$212.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $407.16 / $407.16	Professional		$71.34	$407.16	$407.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $116.51 / $212.20 / $373.71	Facility		$116.51	$212.20	$373.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $212.20 / $236.22 / $407.16	Professional		$212.20	$236.22	$407.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $204.59	Professional		$65.00	$85.00	$204.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $116.51 / $203.58 / $212.20	Facility		$116.51	$203.58	$212.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $407.16 / $407.16	Professional		$71.34	$407.16	$407.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $316.89 / $675.00	Professional		$203.58	$316.89	$675.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $203.58 / $203.58 / $1,029.40	Facility		$203.58	$203.58	$1,029.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $203.58 / $203.58	Professional		$203.58	$203.58	$203.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $247.35 / $285.83 / $324.72	Professional		$247.35	$285.83	$324.72
United Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $226.63 / $299.48	Professional		$203.58	$226.63	$299.48