Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $231.90 / $289.88 / $430.95	Facility		$231.90	$289.88	$430.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $183.59 / $299.73	Professional		$148.80	$183.59	$299.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $415.49 / $502.45 / $531.44	Facility		$415.49	$502.45	$531.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $193.25 / $827.73	Professional		$77.30	$193.25	$827.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $287.02 / $490.86	Facility		$193.25	$287.02	$490.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $202.91 / $249.69	Professional		$193.25	$202.91	$249.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $531.66 / $621.29 / $953.07	Facility		$531.66	$621.29	$953.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.78 / $520.39 / $591.35	Professional		$221.78	$520.39	$591.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $148.80 / $231.90 / $676.38	Facility		$148.80	$231.90	$676.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.93 / $231.90 / $676.38	Facility		$173.93	$231.90	$676.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.60 / $119.14 / $595.95	Professional		$98.60	$119.14	$595.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $193.25	Professional		$50.00	$70.00	$193.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $148.80 / $231.90 / $676.38	Facility		$148.80	$231.90	$676.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $377.16 / $470.91 / $645.83	Professional		$377.16	$470.91	$645.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,189.41 / $1,189.41 / $1,189.41	Facility		$1,189.41	$1,189.41	$1,189.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $183.03 / $966.25 / $966.25	Professional		$183.03	$966.25	$966.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $148.93 / $148.93 / $411.53	Professional		$148.93	$148.93	$411.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $148.93 / $490.53 / $1,055.15	Professional		$148.93	$490.53	$1,055.15
United Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $193.25 / $193.25	Facility		$193.25	$193.25	$193.25
United Facility/Professional Professional Modifier Low / Median / High Price $84.01 / $118.31 / $414.10	Professional		$84.01	$118.31	$414.10