Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.08 / $959.21 / $1,129.84	Facility		$489.08	$959.21	$1,129.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $474.83 / $489.08 / $1,010.30	Professional		$474.83	$489.08	$1,010.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $593.54 / $878.45 / $1,058.89	Facility		$593.54	$878.45	$1,058.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $474.84 / $474.84 / $603.04	Professional		$474.84	$474.84	$603.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $702.76 / $759.74 / $870.34	Facility		$702.76	$759.74	$870.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $474.84 / $697.34 / $1,275.70	Facility		$474.84	$697.34	$1,275.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $480.53 / $645.01 / $732.96	Professional		$480.53	$645.01	$732.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $224.55 / $491.90 / $635.64	Facility		$224.55	$491.90	$635.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $102.88 / $949.68 / $949.68	Professional		$102.88	$949.68	$949.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $224.55 / $491.90 / $635.64	Facility		$224.55	$491.90	$635.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $491.90 / $547.59 / $949.68	Professional		$491.90	$547.59	$949.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $471.63	Professional		$65.00	$85.00	$471.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $224.55 / $491.90 / $635.64	Facility		$224.55	$491.90	$635.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $102.88 / $949.68 / $949.68	Professional		$102.88	$949.68	$949.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $474.84 / $731.02 / $1,488.00	Professional		$474.84	$731.02	$1,488.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $474.84 / $474.84 / $2,358.15	Facility		$474.84	$474.84	$2,358.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $474.84 / $474.84 / $474.84	Professional		$474.84	$474.84	$474.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $305.62 / $666.68 / $749.37	Professional		$305.62	$666.68	$749.37
United Facility/Professional Professional Modifier Low / Median / High Price $474.84 / $528.60 / $712.26	Professional		$474.84	$528.60	$712.26