Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.71 / $473.24 / $543.47	Facility		$243.71	$473.24	$543.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $238.98 / $283.94	Professional		$236.62	$238.98	$283.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.77 / $437.75 / $527.66	Facility		$295.77	$437.75	$527.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $236.62 / $319.43	Professional		$236.62	$236.62	$319.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $378.59 / $425.92 / $433.70	Facility		$378.59	$425.92	$433.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $236.62 / $349.28 / $638.98	Facility		$236.62	$349.28	$638.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $296.91 / $444.30	Professional		$236.62	$296.91	$444.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $217.49 / $236.62 / $260.27	Facility		$217.49	$236.62	$260.27
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $354.93 / $473.24 / $473.24	Professional		$354.93	$473.24	$473.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $217.49 / $236.62 / $261.64	Facility		$217.49	$236.62	$261.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $263.41 / $1,029.23	Professional		$236.62	$263.41	$1,029.23
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 $217.49 / $236.62 / $260.27	Facility		$217.49	$236.62	$260.27
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $354.93 / $473.24 / $473.24	Professional		$354.93	$473.24	$473.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $236.61 / $361.33 / $721.00	Professional		$236.61	$361.33	$721.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $233.12 / $236.62 / $1,165.59	Facility		$233.12	$236.62	$1,165.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $428.84 / $1,029.23	Professional		$236.62	$428.84	$1,029.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $205.23 / $332.21 / $346.65	Professional		$205.23	$332.21	$346.65
United Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $248.45 / $283.94	Professional		$236.62	$248.45	$283.94