Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $387.77 / $734.14 / $864.73	Facility		$387.77	$734.14	$864.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $377.51 / $388.85 / $788.46	Professional		$377.51	$388.85	$788.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $471.90 / $698.41 / $841.87	Facility		$471.90	$698.41	$841.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $377.52 / $377.52 / $479.45	Professional		$377.52	$377.52	$479.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $558.73 / $604.03 / $691.96	Facility		$558.73	$604.03	$691.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $377.52 / $901.36 / $1,288.44	Facility		$377.52	$901.36	$1,288.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $377.44 / $572.79 / $650.90	Professional		$377.44	$572.79	$650.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $257.01 / $376.48 / $831.88	Facility		$257.01	$376.48	$831.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $105.02 / $755.04 / $755.04	Professional		$105.02	$755.04	$755.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $257.01 / $376.48 / $829.75	Facility		$257.01	$376.48	$829.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $376.48 / $419.10 / $755.04	Professional		$376.48	$419.10	$755.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $370.46	Professional		$65.00	$85.00	$370.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $257.01 / $376.48 / $831.88	Facility		$257.01	$376.48	$831.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $105.02 / $755.04 / $755.04	Professional		$105.02	$755.04	$755.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $377.52 / $465.66 / $1,144.00	Professional		$377.52	$465.66	$1,144.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $377.52 / $377.52 / $1,852.30	Facility		$377.52	$377.52	$1,852.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $377.52 / $377.52 / $377.52	Professional		$377.52	$377.52	$377.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $349.77 / $530.04 / $530.04	Professional		$349.77	$530.04	$530.04
United Facility/Professional Professional Modifier Low / Median / High Price $377.52 / $420.26 / $504.31	Professional		$377.52	$420.26	$504.31