Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $339.77 / $339.77 / $339.77	Facility		$339.77	$339.77	$339.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.12 / $339.77 / $1,337.58	Professional		$322.12	$339.77	$1,337.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $463.60 / $463.60 / $764.94	Facility		$463.60	$463.60	$764.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $431.15 / $431.15 / $509.96	Professional		$431.15	$431.15	$509.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $417.24 / $992.10 / $992.10	Facility		$417.24	$992.10	$992.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,246.25 / $1,456.34 / $2,234.06	Facility		$1,246.25	$1,456.34	$2,234.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.25 / $671.72 / $877.39	Professional		$208.25	$671.72	$877.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $322.12 / $463.60 / $486.78	Facility		$322.12	$463.60	$486.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $166.48 / $166.48 / $166.48	Professional		$166.48	$166.48	$166.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $339.77 / $463.60 / $2,169.65	Facility		$339.77	$463.60	$2,169.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $231.28 / $524.24 / $1,407.81	Professional		$231.28	$524.24	$1,407.81
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 $322.12 / $463.60 / $486.78	Facility		$322.12	$463.60	$486.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $166.48 / $166.48 / $166.48	Professional		$166.48	$166.48	$166.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $463.60 / $695.40 / $1,095.33	Professional		$463.60	$695.40	$1,095.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $905.46 / $941.11 / $2,169.65	Facility		$905.46	$941.11	$2,169.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.25 / $208.25 / $208.25	Professional		$208.25	$208.25	$208.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $463.60 / $463.60 / $463.60	Professional		$463.60	$463.60	$463.60
Security Health Facility/Professional Facility Modifier Low / Median / High Price $335.64 / $335.64 / $335.64	Facility		$335.64	$335.64	$335.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $463.60 / $463.60 / $463.60	Professional		$463.60	$463.60	$463.60
United Facility/Professional Professional Modifier Low / Median / High Price $181.09 / $463.60 / $1,407.81	Professional		$181.09	$463.60	$1,407.81