Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.55 / $224.55 / $224.55	Facility		$224.55	$224.55	$224.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.81 / $197.32 / $264.27	Professional		$140.81	$197.32	$264.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $312.70 / $569.11 / $569.11	Facility		$312.70	$569.11	$569.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $290.77 / $312.66 / $422.09	Professional		$290.77	$312.66	$422.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.15 / $220.42 / $672.77	Facility		$30.15	$220.42	$672.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.05 / $204.05 / $806.50	Facility		$204.05	$204.05	$806.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.44 / $349.88 / $437.34	Professional		$173.44	$349.88	$437.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $196.00 / $335.34 / $482.05	Facility		$196.00	$335.34	$482.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $278.47 / $278.47 / $503.00	Professional		$278.47	$278.47	$503.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $196.00 / $483.94 / $1,464.56	Facility		$196.00	$483.94	$1,464.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $166.93 / $226.12 / $415.39	Professional		$166.93	$226.12	$415.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $245.80	Professional		$50.00	$65.00	$245.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $196.00 / $336.83 / $482.05	Facility		$196.00	$336.83	$482.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $278.47 / $278.47 / $503.00	Professional		$278.47	$278.47	$503.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.28 / $70.20 / $91.15	Professional		$41.28	$70.20	$91.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $204.05 / $607.10 / $1,464.56	Facility		$204.05	$607.10	$1,464.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $204.05 / $204.05 / $273.18	Professional		$204.05	$204.05	$273.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $376.58 / $376.58 / $376.58	Professional		$376.58	$376.58	$376.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $376.58 / $376.58 / $376.58	Professional		$376.58	$376.58	$376.58
United Facility/Professional Facility Modifier Low / Median / High Price $18.53 / $162.94 / $219.99	Facility		$18.53	$162.94	$219.99
United Facility/Professional Professional Modifier Low / Median / High Price $139.80 / $222.57 / $403.11	Professional		$139.80	$222.57	$403.11