Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $318.07 / $828.48	Facility		$142.63	$318.07	$828.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.84 / $142.63 / $272.18	Professional		$131.84	$142.63	$272.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.05 / $130.94 / $610.91	Professional		$57.05	$130.94	$610.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $171.16 / $362.28	Facility		$142.63	$171.16	$362.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $149.76 / $184.44	Professional		$142.63	$149.76	$184.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $311.25 / $409.54 / $557.95	Facility		$311.25	$409.54	$557.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.01 / $384.08 / $436.45	Professional		$160.01	$384.08	$436.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $156.88 / $499.21	Facility		$142.63	$156.88	$499.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $256.50 / $499.21	Facility		$142.63	$256.50	$499.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $120.56 / $467.48	Professional		$75.81	$120.56	$467.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $142.63	Professional		$50.00	$70.00	$142.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $156.88 / $499.21	Facility		$142.63	$156.88	$499.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.31 / $340.14 / $477.07	Professional		$256.31	$340.14	$477.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $285.26 / $677.49 / $677.49	Facility		$285.26	$677.49	$677.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $111.11 / $570.52 / $710.30	Professional		$111.11	$570.52	$710.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $303.74	Professional		$142.63	$142.63	$303.74
Security Health Facility/Professional Facility Modifier Low / Median / High Price $171.16 / $171.16 / $171.16	Facility		$171.16	$171.16	$171.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $414.48 / $778.76	Professional		$142.63	$414.48	$778.76
United Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $142.63 / $142.63	Facility		$142.63	$142.63	$142.63
United Facility/Professional Professional Modifier Low / Median / High Price $64.18 / $95.27 / $266.42	Professional		$64.18	$95.27	$266.42