Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $393.09 / $744.20 / $876.59	Facility		$393.09	$744.20	$876.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.85 / $396.39 / $1,156.97	Professional		$384.85	$396.39	$1,156.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $481.06 / $711.97 / $858.22	Facility		$481.06	$711.97	$858.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $384.85 / $384.85 / $508.28	Professional		$384.85	$384.85	$508.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $615.76 / $692.73 / $705.39	Facility		$615.76	$692.73	$705.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.06 / $756.20 / $1,311.81	Facility		$363.06	$756.20	$1,311.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $388.69 / $585.87 / $665.76	Professional		$388.69	$585.87	$665.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $381.64 / $381.64 / $848.28	Facility		$381.64	$381.64	$848.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $572.46 / $769.70 / $769.70	Professional		$572.46	$769.70	$769.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $381.64 / $381.64 / $841.14	Facility		$381.64	$381.64	$841.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $381.64 / $424.85 / $769.70	Professional		$381.64	$424.85	$769.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $381.50	Professional		$85.00	$85.00	$381.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $381.64 / $381.64 / $848.28	Facility		$381.64	$381.64	$848.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $572.46 / $769.70 / $769.70	Professional		$572.46	$769.70	$769.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $384.84 / $500.29 / $1,280.40	Professional		$384.84	$500.29	$1,280.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $384.85 / $384.85 / $2,207.94	Facility		$384.85	$384.85	$2,207.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $384.85 / $384.85 / $384.85	Professional		$384.85	$384.85	$384.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $540.33 / $540.33 / $540.33	Professional		$540.33	$540.33	$540.33
United Facility/Professional Professional Modifier Low / Median / High Price $384.85 / $428.42 / $514.10	Professional		$384.85	$428.42	$514.10