Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.87 / $179.87 / $179.87	Facility		$179.87	$179.87	$179.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.74 / $161.96 / $209.71	Professional		$111.74	$161.96	$209.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $254.40 / $463.01 / $463.01	Facility		$254.40	$463.01	$463.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $236.56 / $254.37 / $343.39	Professional		$236.56	$254.37	$343.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.33 / $174.92 / $544.35	Facility		$23.33	$174.92	$544.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.31 / $166.31 / $680.35	Facility		$166.31	$166.31	$680.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.31 / $295.13 / $368.91	Professional		$166.31	$295.13	$368.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $259.32 / $372.77	Facility		$158.00	$259.32	$372.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $215.34 / $215.34 / $388.98	Professional		$215.34	$215.34	$388.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $388.50 / $1,193.68	Facility		$158.00	$388.50	$1,193.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.13 / $179.26 / $335.30	Professional		$129.13	$179.26	$335.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $209.80	Professional		$50.00	$65.00	$209.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $259.32 / $372.77	Facility		$158.00	$259.32	$372.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $215.34 / $215.34 / $388.98	Professional		$215.34	$215.34	$388.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.58 / $56.79 / $73.73	Professional		$33.58	$56.79	$73.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $166.31 / $493.92 / $1,193.68	Facility		$166.31	$493.92	$1,193.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $166.31 / $166.31 / $218.29	Professional		$166.31	$166.31	$218.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $298.98 / $298.98 / $298.98	Professional		$298.98	$298.98	$298.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $298.98 / $298.98 / $298.98	Professional		$298.98	$298.98	$298.98
United Facility/Professional Professional Modifier Low / Median / High Price $108.11 / $174.86 / $300.22	Professional		$108.11	$174.86	$300.22