Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $403.85 / $587.19 / $904.69	Facility		$403.85	$587.19	$904.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.09 / $407.93 / $676.67	Professional		$392.09	$407.93	$676.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $490.11 / $490.11 / $874.36	Facility		$490.11	$490.11	$874.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $392.09 / $392.09 / $588.13	Professional		$392.09	$392.09	$588.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $536.79 / $580.29 / $627.34	Facility		$536.79	$580.29	$627.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $392.09 / $963.73 / $1,377.59	Facility		$392.09	$963.73	$1,377.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $401.85 / $611.85 / $695.29	Professional		$401.85	$611.85	$695.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $371.94 / $393.87 / $605.78	Facility		$371.94	$393.87	$605.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $77.50 / $784.18 / $784.18	Professional		$77.50	$784.18	$784.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $392.09 / $413.57 / $1,973.75	Facility		$392.09	$413.57	$1,973.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.55 / $393.87 / $539.29	Professional		$157.55	$393.87	$539.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $394.41	Professional		$50.00	$65.00	$394.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $371.94 / $393.87 / $605.78	Facility		$371.94	$393.87	$605.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $77.50 / $784.18 / $784.18	Professional		$77.50	$784.18	$784.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $392.09 / $479.27 / $1,320.49	Professional		$392.09	$479.27	$1,320.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,577.64 / $1,577.64 / $1,973.75	Facility		$1,577.64	$1,577.64	$1,973.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $392.09 / $392.09 / $401.08	Professional		$392.09	$392.09	$401.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $495.63 / $550.49 / $577.74	Professional		$495.63	$550.49	$577.74
United Facility/Professional Professional Modifier Low / Median / High Price $294.07 / $392.09 / $494.03	Professional		$294.07	$392.09	$494.03