Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.77 / $395.30 / $453.98	Facility		$203.77	$395.30	$453.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $199.81 / $239.16	Professional		$197.83	$199.81	$239.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $247.29 / $365.99 / $441.16	Facility		$247.29	$365.99	$441.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $267.07	Professional		$197.83	$197.83	$267.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $316.52 / $356.09 / $362.60	Facility		$316.52	$356.09	$362.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $197.83 / $254.91 / $529.91	Facility		$197.83	$254.91	$529.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $237.02 / $331.68	Professional		$197.83	$237.02	$331.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $197.65 / $199.81 / $218.77	Facility		$197.65	$199.81	$218.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $296.48 / $395.66 / $395.66	Professional		$296.48	$395.66	$395.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $197.65 / $197.65 / $219.58	Facility		$197.65	$197.65	$219.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $197.65 / $220.03 / $855.93	Professional		$197.65	$220.03	$855.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $187.00	Professional		$50.00	$70.00	$187.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $197.65 / $197.83 / $220.18	Facility		$197.65	$197.83	$220.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $296.48 / $395.66 / $395.66	Professional		$296.48	$395.66	$395.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $300.82 / $647.28	Professional		$197.83	$300.82	$647.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $194.08 / $197.83 / $970.40	Facility		$194.08	$197.83	$970.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $356.64 / $855.93	Professional		$197.83	$356.64	$855.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $268.61 / $277.75 / $277.75	Professional		$268.61	$277.75	$277.75
United Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $207.72 / $250.28	Professional		$197.83	$207.72	$250.28