Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $402.80 / $766.14 / $879.87	Facility		$402.80	$766.14	$879.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $391.06 / $394.98 / $463.52	Professional		$391.06	$394.98	$463.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $488.84 / $723.48 / $872.09	Facility		$488.84	$723.48	$872.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $391.07 / $391.07 / $527.94	Professional		$391.07	$391.07	$527.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $625.71 / $703.93 / $716.79	Facility		$625.71	$703.93	$716.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $391.07 / $551.79 / $1,009.46	Facility		$391.07	$551.79	$1,009.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.81 / $463.36 / $664.45	Professional		$381.81	$463.36	$664.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $331.83 / $391.07 / $430.18	Facility		$331.83	$391.07	$430.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $574.61 / $782.14 / $782.14	Professional		$574.61	$782.14	$782.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $331.83 / $383.07 / $426.35	Facility		$331.83	$383.07	$426.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $383.07 / $426.44 / $1,601.59	Professional		$383.07	$426.44	$1,601.59
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 $331.83 / $391.07 / $432.45	Facility		$331.83	$391.07	$432.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $574.61 / $782.14 / $782.14	Professional		$574.61	$782.14	$782.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $391.07 / $563.94 / $1,121.00	Professional		$391.07	$563.94	$1,121.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $376.31 / $391.07 / $1,819.15	Facility		$376.31	$391.07	$1,819.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $391.07 / $667.33 / $1,601.59	Professional		$391.07	$667.33	$1,601.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $375.79 / $549.05 / $549.05	Professional		$375.79	$549.05	$549.05
United Facility/Professional Professional Modifier Low / Median / High Price $391.07 / $413.57 / $465.37	Professional		$391.07	$413.57	$465.37