Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $367.64 / $697.24 / $800.73	Facility		$367.64	$697.24	$800.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $356.93 / $360.50 / $428.32	Professional		$356.93	$360.50	$428.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.16 / $660.32 / $795.95	Facility		$446.16	$660.32	$795.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $356.93 / $356.93 / $481.85	Professional		$356.93	$356.93	$481.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $571.09 / $642.47 / $654.22	Facility		$571.09	$642.47	$654.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $356.93 / $678.15 / $1,176.43	Facility		$356.93	$678.15	$1,176.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $355.27 / $431.16 / $576.98	Professional		$355.27	$431.16	$576.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $348.62 / $356.93 / $394.70	Facility		$348.62	$356.93	$394.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $522.92 / $713.86 / $713.86	Professional		$522.92	$713.86	$713.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $348.62 / $348.62 / $385.50	Facility		$348.62	$348.62	$385.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $348.62 / $388.09 / $1,496.24	Professional		$348.62	$388.09	$1,496.24
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 $348.62 / $356.93 / $397.27	Facility		$348.62	$356.93	$397.27
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $522.92 / $713.86 / $713.86	Professional		$522.92	$713.86	$713.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $356.93 / $450.43 / $1,152.80	Professional		$356.93	$450.43	$1,152.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $344.32 / $356.93 / $1,692.65	Facility		$344.32	$356.93	$1,692.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $356.93 / $623.42 / $1,496.24	Professional		$356.93	$623.42	$1,496.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $501.13 / $501.13 / $501.13	Professional		$501.13	$501.13	$501.13
United Facility/Professional Professional Modifier Low / Median / High Price $355.46 / $358.84 / $424.75	Professional		$355.46	$358.84	$424.75