Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.14 / $453.93 / $674.84	Facility		$363.14	$453.93	$674.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.02 / $287.49 / $453.93	Professional		$233.02	$287.49	$453.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $650.63 / $786.81 / $832.21	Facility		$650.63	$786.81	$832.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.05 / $121.05 / $1,210.48	Professional		$121.05	$121.05	$1,210.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $739.58 / $739.58 / $768.65	Facility		$739.58	$739.58	$768.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $832.63 / $973.00 / $1,492.61	Facility		$832.63	$973.00	$1,492.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.87 / $763.66 / $926.01	Professional		$144.87	$763.66	$926.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $117.00 / $363.14 / $1,059.17	Facility		$117.00	$363.14	$1,059.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.00 / $363.14 / $1,059.17	Facility		$117.00	$363.14	$1,059.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.13 / $181.57 / $1,513.10	Professional		$34.13	$181.57	$1,513.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $151.31	Professional		$50.00	$70.00	$151.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $117.00 / $363.14 / $1,059.17	Facility		$117.00	$363.14	$1,059.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $176.95 / $721.94 / $1,012.56	Professional		$176.95	$721.94	$1,012.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $605.24 / $1,437.45 / $1,437.45	Facility		$605.24	$1,437.45	$1,437.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $110.18 / $1,513.10 / $1,513.10	Professional		$110.18	$1,513.10	$1,513.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.96 / $42.96 / $644.44	Professional		$42.96	$42.96	$644.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.96 / $141.50 / $1,652.31	Professional		$42.96	$141.50	$1,652.31
United Facility/Professional Facility Modifier Low / Median / High Price $302.62 / $302.62 / $302.62	Facility		$302.62	$302.62	$302.62
United Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $181.57 / $469.06	Professional		$34.43	$181.57	$469.06