Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.73 / $414.10 / $487.77	Facility		$218.73	$414.10	$487.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $220.26 / $293.66	Professional		$213.84	$220.26	$293.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $267.30 / $395.60 / $476.86	Facility		$267.30	$395.60	$476.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $271.57	Professional		$213.84	$213.84	$271.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $292.77 / $292.77 / $342.14	Facility		$292.77	$292.77	$342.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.84 / $509.47 / $728.26	Facility		$213.84	$509.47	$728.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.86 / $321.60 / $365.45	Professional		$213.86	$321.60	$365.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $212.36 / $212.36 / $471.19	Facility		$212.36	$212.36	$471.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $318.54 / $427.68 / $427.68	Professional		$318.54	$427.68	$427.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $212.36 / $212.36 / $468.33	Facility		$212.36	$212.36	$468.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $212.36 / $212.36 / $427.68	Professional		$212.36	$212.36	$427.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $209.91	Professional		$85.00	$85.00	$209.91
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $212.36 / $212.36 / $471.19	Facility		$212.36	$212.36	$471.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $318.54 / $427.68 / $427.68	Professional		$318.54	$427.68	$427.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $278.94 / $713.90	Professional		$213.84	$278.94	$713.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,049.55 / $1,049.55 / $1,049.55	Facility		$1,049.55	$1,049.55	$1,049.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $213.84	Professional		$213.84	$213.84	$213.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $300.23 / $300.23 / $300.23	Professional		$300.23	$300.23	$300.23
United Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $213.84 / $277.99	Professional		$213.84	$213.84	$277.99