Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $364.97 / $364.97 / $364.97	Facility		$364.97	$364.97	$364.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.73 / $323.74 / $434.92	Professional		$231.73	$323.74	$434.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $512.20 / $932.20 / $932.20	Facility		$512.20	$932.20	$932.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $476.35 / $476.36 / $691.47	Professional		$476.35	$476.36	$691.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.11 / $361.11 / $1,432.37	Facility		$36.11	$361.11	$1,432.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $333.25 / $333.25 / $1,339.97	Facility		$333.25	$333.25	$1,339.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $333.25 / $581.63 / $727.03	Professional		$333.25	$581.63	$727.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $315.00 / $535.46 / $769.73	Facility		$315.00	$535.46	$769.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $383.24 / $383.24 / $803.20	Professional		$383.24	$383.24	$803.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $315.00 / $803.20 / $2,391.90	Facility		$315.00	$803.20	$2,391.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $240.56 / $328.04 / $665.91	Professional		$240.56	$328.04	$665.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $410.80	Professional		$50.00	$65.00	$410.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $315.00 / $535.46 / $769.73	Facility		$315.00	$535.46	$769.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $383.24 / $383.24 / $803.20	Professional		$383.24	$383.24	$803.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $112.80 / $146.46	Professional		$67.61	$112.80	$146.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $333.25 / $994.60 / $2,391.90	Facility		$333.25	$994.60	$2,391.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $333.25 / $333.25 / $440.85	Professional		$333.25	$333.25	$440.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $608.04 / $608.04 / $608.04	Professional		$608.04	$608.04	$608.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $608.04 / $608.04 / $608.04	Professional		$608.04	$608.04	$608.04
United Facility/Professional Professional Modifier Low / Median / High Price $211.28 / $311.50 / $655.16	Professional		$211.28	$311.50	$655.16