Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.41 / $433.48 / $497.85	Facility		$223.41	$433.48	$497.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $219.07 / $251.61	Professional		$216.90	$219.07	$251.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $271.13 / $401.27 / $483.69	Facility		$271.13	$401.27	$483.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $292.81	Professional		$216.90	$216.90	$292.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $347.04 / $390.42 / $397.56	Facility		$347.04	$390.42	$397.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $313.85 / $716.13	Facility		$216.90	$313.85	$716.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $270.00 / $355.56	Professional		$216.90	$270.00	$355.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $216.74 / $217.33 / $239.85	Facility		$216.74	$217.33	$239.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $325.11 / $433.80 / $433.80	Professional		$325.11	$433.80	$433.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $216.74 / $216.74 / $239.68	Facility		$216.74	$216.74	$239.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $216.74 / $241.28 / $936.51	Professional		$216.74	$241.28	$936.51
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 $216.74 / $216.90 / $241.42	Facility		$216.74	$216.90	$241.42
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $325.11 / $433.80 / $433.80	Professional		$325.11	$433.80	$433.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $328.59 / $708.87	Professional		$216.90	$328.59	$708.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $212.42 / $216.90 / $1,060.00	Facility		$212.42	$216.90	$1,060.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $390.21 / $936.51	Professional		$216.90	$390.21	$936.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $304.52 / $304.52 / $304.52	Professional		$304.52	$304.52	$304.52
United Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $227.75 / $258.11	Professional		$216.90	$227.75	$258.11