Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.15 / $303.52 / $446.34	Facility		$200.15	$303.52	$446.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.93 / $294.69 / $333.84	Professional		$187.93	$294.69	$333.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $368.36 / $545.17 / $657.16	Facility		$368.36	$545.17	$657.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $294.69 / $294.69 / $374.25	Professional		$294.69	$294.69	$374.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $403.46 / $403.46 / $471.50	Facility		$403.46	$403.46	$471.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $294.69 / $1,325.69 / $1,894.98	Facility		$294.69	$1,325.69	$1,894.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.20 / $259.31 / $362.11	Professional		$228.20	$259.31	$362.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.88 / $194.32 / $649.39	Facility		$70.88	$194.32	$649.39
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1.87 / $589.38 / $589.38	Professional		$1.87	$589.38	$589.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.88 / $194.32 / $428.41	Facility		$70.88	$194.32	$428.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.32 / $194.32 / $447.37	Professional		$194.32	$194.32	$447.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $284.33	Professional		$65.00	$85.00	$284.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $70.88 / $194.32 / $649.39	Facility		$70.88	$194.32	$649.39
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1.87 / $589.38 / $589.38	Professional		$1.87	$589.38	$589.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $203.59 / $294.69 / $566.00	Professional		$203.59	$294.69	$566.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $294.69 / $294.69 / $2,184.28	Facility		$294.69	$294.69	$2,184.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $294.69 / $294.69 / $294.69	Professional		$294.69	$294.69	$294.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $413.74 / $413.74	Professional		$96.63	$413.74	$413.74
United Facility/Professional Professional Modifier Low / Median / High Price $294.69 / $294.69 / $442.04	Professional		$294.69	$294.69	$442.04