Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.60 / $434.18 / $498.63	Facility		$223.60	$434.18	$498.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $219.26 / $251.82	Professional		$217.09	$219.26	$251.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $271.36 / $401.62 / $484.11	Facility		$271.36	$401.62	$484.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $217.09 / $293.07	Professional		$217.09	$217.09	$293.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $347.34 / $390.76 / $397.91	Facility		$347.34	$390.76	$397.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $217.09 / $429.60 / $745.25	Facility		$217.09	$429.60	$745.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $273.52 / $370.28	Professional		$217.09	$273.52	$370.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $217.09 / $219.26 / $240.06	Facility		$217.09	$219.26	$240.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $325.64 / $434.18 / $434.18	Professional		$325.64	$434.18	$434.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $217.09 / $217.09 / $241.19	Facility		$217.09	$217.09	$241.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $241.67 / $948.17	Professional		$217.09	$241.67	$948.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $524.01	Professional		$50.00	$70.00	$524.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $217.09 / $217.09 / $241.62	Facility		$217.09	$217.09	$241.62
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $325.64 / $434.18 / $434.18	Professional		$325.64	$434.18	$434.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $332.87 / $717.52	Professional		$217.09	$332.87	$717.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $214.76 / $217.09 / $1,073.80	Facility		$214.76	$217.09	$1,073.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $395.07 / $948.17	Professional		$217.09	$395.07	$948.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $304.79 / $304.79 / $304.79	Professional		$304.79	$304.79	$304.79
United Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $227.94 / $258.33	Professional		$217.09	$227.94	$258.33