Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $361.62 / $452.03 / $672.01	Facility		$361.62	$452.03	$672.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.04 / $286.27 / $458.05	Professional		$232.04	$286.27	$458.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $647.90 / $783.51 / $828.71	Facility		$647.90	$783.51	$828.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.54 / $301.35 / $1,290.75	Professional		$120.54	$301.35	$1,290.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $301.35 / $447.59 / $797.85	Facility		$301.35	$447.59	$797.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $301.35 / $316.42 / $389.81	Professional		$301.35	$316.42	$389.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $829.03 / $968.79 / $1,486.15	Facility		$829.03	$968.79	$1,486.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.51 / $811.47 / $922.13	Professional		$346.51	$811.47	$922.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $232.04 / $361.62 / $1,054.73	Facility		$232.04	$361.62	$1,054.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $271.22 / $361.62 / $1,054.73	Facility		$271.22	$361.62	$1,054.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $150.68 / $180.81 / $929.32	Professional		$150.68	$180.81	$929.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $150.68	Professional		$50.00	$70.00	$150.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $232.04 / $361.62 / $1,054.73	Facility		$232.04	$361.62	$1,054.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $572.92 / $735.16 / $1,008.24	Professional		$572.92	$735.16	$1,008.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,601.02 / $1,601.02 / $1,601.02	Facility		$1,601.02	$1,601.02	$1,601.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $436.96 / $1,506.75 / $1,506.75	Professional		$436.96	$1,506.75	$1,506.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $301.35 / $301.35 / $641.74	Professional		$301.35	$301.35	$641.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $301.35 / $301.35 / $1,645.37	Professional		$301.35	$301.35	$1,645.37
United Facility/Professional Facility Modifier Low / Median / High Price $301.35 / $301.35 / $301.35	Facility		$301.35	$301.35	$301.35
United Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $180.81 / $632.84	Professional		$131.00	$180.81	$632.84