Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $266.39 / $517.04 / $593.78	Facility		$266.39	$517.04	$593.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $266.27 / $355.19	Professional		$258.64	$266.27	$355.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.30 / $478.48 / $576.77	Facility		$323.30	$478.48	$576.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $258.64 / $349.16	Professional		$258.64	$258.64	$349.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $413.82 / $465.55 / $474.06	Facility		$413.82	$465.55	$474.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $258.64 / $364.79 / $667.34	Facility		$258.64	$364.79	$667.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $304.87 / $452.80	Professional		$258.64	$304.87	$452.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $181.93 / $258.64 / $364.92	Facility		$181.93	$258.64	$364.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $387.78 / $517.28 / $517.28	Professional		$387.78	$517.28	$517.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $181.93 / $258.52 / $361.92	Facility		$181.93	$258.52	$361.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $258.52 / $287.79 / $6,942.60	Professional		$258.52	$287.79	$6,942.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $162.44 / $258.64 / $364.92	Facility		$162.44	$258.64	$364.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $387.78 / $517.28 / $517.28	Professional		$387.78	$517.28	$517.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $285.60 / $770.00	Professional		$258.64	$285.60	$770.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $248.93 / $258.64 / $1,244.65	Facility		$248.93	$258.64	$1,244.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $457.94 / $6,942.60	Professional		$258.64	$457.94	$6,942.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $195.90 / $363.13 / $363.13	Professional		$195.90	$363.13	$363.13
United Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $274.16 / $307.77	Professional		$258.64	$274.16	$307.77