Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $266.62 / $266.62 / $266.62	Facility		$266.62	$266.62	$266.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.97 / $198.06 / $320.88	Professional		$170.97	$198.06	$320.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $367.50 / $668.85 / $668.85	Facility		$367.50	$668.85	$668.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $341.78 / $367.50 / $496.13	Professional		$341.78	$367.50	$496.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.61 / $259.10 / $816.62	Facility		$36.61	$259.10	$816.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.78 / $243.78 / $993.03	Facility		$243.78	$243.78	$993.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.78 / $430.88 / $538.59	Professional		$243.78	$430.88	$538.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $232.00 / $407.07 / $585.16	Facility		$232.00	$407.07	$585.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $338.03 / $338.03 / $610.61	Professional		$338.03	$338.03	$610.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $266.62 / $587.66 / $1,749.66	Facility		$266.62	$587.66	$1,749.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.22 / $274.50 / $491.55	Professional		$198.22	$274.50	$491.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $341.41	Professional		$50.00	$65.00	$341.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $232.00 / $407.07 / $585.16	Facility		$232.00	$407.07	$585.16
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $338.03 / $338.03 / $610.61	Professional		$338.03	$338.03	$610.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.51 / $78.88 / $102.42	Professional		$48.51	$78.88	$102.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $243.78 / $713.62 / $1,749.66	Facility		$243.78	$713.62	$1,749.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $243.78 / $243.78 / $326.36	Professional		$243.78	$243.78	$326.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $453.52 / $453.52 / $453.52	Professional		$453.52	$453.52	$453.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $453.52 / $453.52 / $453.52	Professional		$453.52	$453.52	$453.52
United Facility/Professional Professional Modifier Low / Median / High Price $169.70 / $265.94 / $471.27	Professional		$169.70	$265.94	$471.27