Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.02 / $182.02 / $182.02	Facility		$182.02	$182.02	$182.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.87 / $157.68 / $215.58	Professional		$114.87	$157.68	$215.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $250.30 / $455.55 / $455.55	Facility		$250.30	$455.55	$455.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.78 / $250.30 / $337.90	Professional		$232.78	$250.30	$337.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $176.48 / $560.23	Facility		$25.12	$176.48	$560.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $160.96 / $631.69	Facility		$160.96	$160.96	$631.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.96 / $274.13 / $342.66	Professional		$160.96	$274.13	$342.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $279.24 / $401.41	Facility		$180.00	$279.24	$401.41
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $231.88 / $231.88 / $418.86	Professional		$231.88	$231.88	$418.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $182.02 / $391.04 / $1,154.28	Facility		$182.02	$391.04	$1,154.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $135.32 / $188.30 / $330.81	Professional		$135.32	$188.30	$330.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $182.70	Professional		$50.00	$65.00	$182.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $279.24 / $401.41	Facility		$180.00	$279.24	$401.41
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $231.88 / $231.88 / $418.86	Professional		$231.88	$231.88	$418.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $52.85 / $68.62	Professional		$33.04	$52.85	$68.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $486.10 / $1,154.28	Facility		$160.96	$486.10	$1,154.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $160.96 / $160.96 / $215.49	Professional		$160.96	$160.96	$215.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $307.07 / $307.07 / $307.07	Professional		$307.07	$307.07	$307.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $307.07 / $307.07 / $307.07	Professional		$307.07	$307.07	$307.07
United Facility/Professional Professional Modifier Low / Median / High Price $116.41 / $180.43 / $323.27	Professional		$116.41	$180.43	$323.27