Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.38 / $154.38 / $154.38	Facility		$154.38	$154.38	$154.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.04 / $154.38 / $202.47	Professional		$78.04	$154.38	$202.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $265.89 / $265.89 / $438.74	Facility		$265.89	$265.89	$438.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.29 / $265.89 / $303.12	Professional		$247.29	$265.89	$303.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $265.89 / $569.03 / $569.03	Facility		$265.89	$569.03	$569.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.59 / $835.05 / $1,109.84	Facility		$714.59	$835.05	$1,109.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $385.31 / $503.24	Professional		$135.78	$385.31	$503.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $149.32 / $216.13 / $265.89	Facility		$149.32	$216.13	$265.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $152.24 / $152.24 / $265.89	Professional		$152.24	$152.24	$265.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.63 / $219.12 / $277.88	Facility		$150.63	$219.12	$277.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.63 / $150.34 / $336.91	Professional		$123.63	$150.34	$336.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.47 / $70.00 / $282.94	Professional		$13.47	$70.00	$282.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $149.32 / $219.12 / $265.89	Facility		$149.32	$219.12	$265.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $152.24 / $152.24 / $265.89	Professional		$152.24	$152.24	$265.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $265.89 / $398.85 / $674.00	Professional		$265.89	$398.85	$674.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $519.34 / $539.78 / $1,249.08	Facility		$519.34	$539.78	$1,249.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $1,168.52 / $1,324.18	Professional		$135.78	$1,168.52	$1,324.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $265.89 / $265.89 / $265.89	Professional		$265.89	$265.89	$265.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $265.89 / $265.89 / $265.89	Professional		$265.89	$265.89	$265.89
United Facility/Professional Professional Modifier Low / Median / High Price $110.70 / $132.65 / $221.09	Professional		$110.70	$132.65	$221.09