Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.50 / $136.50 / $136.50	Facility		$136.50	$136.50	$136.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.50 / $139.29 / $243.10	Professional		$136.50	$139.29	$243.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.66 / $335.15 / $505.34	Professional		$325.66	$335.15	$505.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $214.26 / $214.26 / $214.26	Facility		$214.26	$214.26	$214.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $409.07 / $1,632.83 / $2,536.01	Facility		$409.07	$1,632.83	$2,536.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $347.71 / $607.88 / $759.84	Professional		$347.71	$607.88	$759.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $136.50 / $245.70 / $396.22	Facility		$136.50	$245.70	$396.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $363.17 / $363.17 / $363.17	Professional		$363.17	$363.17	$363.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $148.34 / $322.45 / $1,416.02	Facility		$148.34	$322.45	$1,416.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.39 / $293.44 / $453.96	Professional		$164.39	$293.44	$453.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $136.50 / $243.10 / $396.22	Facility		$136.50	$243.10	$396.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $363.17 / $363.17 / $363.17	Professional		$363.17	$363.17	$363.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $343.84 / $631.04 / $819.36	Professional		$343.84	$631.04	$819.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $409.07 / $660.65 / $1,416.02	Facility		$409.07	$660.65	$1,416.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $347.71 / $409.07 / $1,871.49	Professional		$347.71	$409.07	$1,871.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $506.46 / $583.91 / $595.83	Professional		$506.46	$583.91	$595.83
United Facility/Professional Facility Modifier Low / Median / High Price $318.88 / $318.88 / $318.88	Facility		$318.88	$318.88	$318.88
United Facility/Professional Professional Modifier Low / Median / High Price $145.85 / $230.98 / $444.63	Professional		$145.85	$230.98	$444.63