Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $369.86 / $700.23 / $824.79	Facility		$369.86	$700.23	$824.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $359.18 / $369.97 / $827.61	Professional		$359.18	$369.97	$827.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $448.99 / $664.50 / $800.99	Facility		$448.99	$664.50	$800.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $359.19 / $359.19 / $456.17	Professional		$359.19	$359.19	$456.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $491.76 / $491.76 / $574.70	Facility		$491.76	$491.76	$574.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $356.67 / $420.86 / $956.72	Facility		$356.67	$420.86	$956.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $359.19 / $511.54 / $581.29	Professional		$359.19	$511.54	$581.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $359.09 / $359.09 / $791.24	Facility		$359.09	$359.09	$791.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $538.64 / $718.38 / $718.38	Professional		$538.64	$718.38	$718.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $359.09 / $359.09 / $791.24	Facility		$359.09	$359.09	$791.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $359.09 / $359.09 / $718.38	Professional		$359.09	$359.09	$718.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $352.56	Professional		$85.00	$85.00	$352.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $359.09 / $359.09 / $791.24	Facility		$359.09	$359.09	$791.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $538.64 / $718.38 / $718.38	Professional		$538.64	$718.38	$718.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $359.19 / $380.74 / $1,180.30	Professional		$359.19	$380.74	$1,180.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,762.80 / $1,762.80 / $1,762.80	Facility		$1,762.80	$1,762.80	$1,762.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $359.19 / $359.19 / $359.19	Professional		$359.19	$359.19	$359.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $504.30 / $504.30 / $504.30	Professional		$504.30	$504.30	$504.30
United Facility/Professional Professional Modifier Low / Median / High Price $359.19 / $359.19 / $754.30	Professional		$359.19	$359.19	$754.30