Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.02 / $189.02 / $189.02	Facility		$189.02	$189.02	$189.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.20 / $189.02 / $744.11	Professional		$179.20	$189.02	$744.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.89 / $257.89 / $425.54	Facility		$257.89	$257.89	$425.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.85 / $239.85 / $283.69	Professional		$239.85	$239.85	$283.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $232.11 / $551.91 / $551.91	Facility		$232.11	$551.91	$551.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $692.96 / $809.78 / $1,242.22	Facility		$692.96	$809.78	$1,242.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $373.59 / $488.10	Professional		$119.00	$373.59	$488.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $179.20 / $257.89 / $270.80	Facility		$179.20	$257.89	$270.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $92.46 / $92.46 / $92.46	Professional		$92.46	$92.46	$92.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $189.02 / $257.89 / $1,206.97	Facility		$189.02	$257.89	$1,206.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.66 / $291.64 / $783.18	Professional		$128.66	$291.64	$783.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $90.00	Professional		$65.00	$65.00	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $179.20 / $257.89 / $270.80	Facility		$179.20	$257.89	$270.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $92.46 / $92.46 / $92.46	Professional		$92.46	$92.46	$92.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.89 / $386.85 / $609.04	Professional		$257.89	$386.85	$609.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $503.72 / $523.54 / $1,206.97	Facility		$503.72	$523.54	$1,206.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $119.00 / $119.00	Professional		$119.00	$119.00	$119.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $257.89 / $257.89 / $257.89	Professional		$257.89	$257.89	$257.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $257.89 / $257.89 / $257.89	Professional		$257.89	$257.89	$257.89
United Facility/Professional Professional Modifier Low / Median / High Price $100.74 / $270.58 / $783.18	Professional		$100.74	$270.58	$783.18