Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.99 / $264.99 / $264.99	Facility		$264.99	$264.99	$264.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.49 / $238.48 / $310.60	Professional		$165.49	$238.48	$310.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $376.20 / $684.68 / $684.68	Facility		$376.20	$684.68	$684.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.84 / $353.12 / $507.82	Professional		$349.84	$353.12	$507.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.04 / $255.38 / $805.00	Facility		$34.04	$255.38	$805.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.17 / $243.17 / $1,004.75	Facility		$243.17	$243.17	$1,004.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.17 / $436.13 / $545.16	Professional		$243.17	$436.13	$545.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $150.34 / $378.66 / $544.32	Facility		$150.34	$378.66	$544.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $314.43 / $314.43 / $567.98	Professional		$314.43	$314.43	$567.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.34 / $567.98 / $1,744.00	Facility		$150.34	$567.98	$1,744.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.57 / $262.62 / $487.06	Professional		$188.57	$262.62	$487.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $292.50	Professional		$50.00	$65.00	$292.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $150.34 / $397.49 / $544.32	Facility		$150.34	$397.49	$544.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $314.43 / $314.43 / $567.98	Professional		$314.43	$314.43	$567.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.66 / $82.82 / $107.54	Professional		$49.66	$82.82	$107.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $243.17 / $730.42 / $1,744.00	Facility		$243.17	$730.42	$1,744.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $243.17 / $243.17 / $319.16	Professional		$243.17	$243.17	$319.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $438.14 / $438.14 / $438.14	Professional		$438.14	$438.14	$438.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $438.14 / $438.14 / $438.14	Professional		$438.14	$438.14	$438.14
United Facility/Professional Professional Modifier Low / Median / High Price $161.47 / $255.33 / $438.38	Professional		$161.47	$255.33	$438.38