Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $258.33 / $258.33 / $258.33	Facility		$258.33	$258.33	$258.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.13 / $197.62 / $305.55	Professional		$163.13	$197.62	$305.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $387.80 / $705.80 / $705.80	Facility		$387.80	$705.80	$705.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.59 / $360.65 / $523.42	Professional		$360.59	$360.65	$523.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.90 / $209.22 / $829.74	Facility		$27.90	$209.22	$829.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $238.16 / $238.16 / $885.80	Facility		$238.16	$238.16	$885.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.16 / $382.13 / $477.66	Professional		$238.16	$382.13	$477.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $106.15 / $258.33 / $464.99	Facility		$106.15	$258.33	$464.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $222.00 / $222.00 / $465.28	Professional		$222.00	$222.00	$465.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $106.15 / $464.99 / $1,682.37	Facility		$106.15	$464.99	$1,682.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $139.35 / $193.43 / $428.44	Professional		$139.35	$193.43	$428.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $106.15 / $283.05 / $464.99	Facility		$106.15	$283.05	$464.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $222.00 / $222.00 / $465.28	Professional		$222.00	$222.00	$465.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.19 / $77.30 / $100.37	Professional		$51.19	$77.30	$100.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $238.16 / $757.28 / $1,682.37	Facility		$238.16	$757.28	$1,682.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $238.16 / $238.16 / $274.02	Professional		$238.16	$238.16	$274.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $387.73 / $387.73 / $387.73	Professional		$387.73	$387.73	$387.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $387.73 / $387.73 / $387.73	Professional		$387.73	$387.73	$387.73
United Facility/Professional Professional Modifier Low / Median / High Price $128.74 / $193.43 / $411.05	Professional		$128.74	$193.43	$411.05