Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $395.11 / $395.11 / $395.11	Facility		$395.11	$395.11	$395.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.25 / $333.40 / $441.52	Professional		$235.25	$333.40	$441.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $577.90 / $1,051.78 / $1,051.78	Facility		$577.90	$1,051.78	$1,051.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.45 / $537.48 / $780.16	Professional		$537.45	$537.48	$780.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.12 / $353.43 / $1,236.79	Facility		$47.12	$353.43	$1,236.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.71 / $358.71 / $1,411.15	Facility		$358.71	$358.71	$1,411.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.71 / $612.38 / $765.47	Professional		$358.71	$612.38	$765.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $208.05 / $524.03 / $753.30	Facility		$208.05	$524.03	$753.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $435.14 / $435.14 / $786.05	Professional		$435.14	$435.14	$786.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.05 / $786.05 / $2,574.69	Facility		$208.05	$786.05	$2,574.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.02 / $362.24 / $709.20	Professional		$270.02	$362.24	$709.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $488.00	Professional		$50.00	$65.00	$488.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $208.05 / $554.80 / $753.30	Facility		$208.05	$554.80	$753.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $435.14 / $435.14 / $786.05	Professional		$435.14	$435.14	$786.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.28 / $120.69 / $156.69	Professional		$76.28	$120.69	$156.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $358.71 / $1,122.20 / $2,574.69	Facility		$358.71	$1,122.20	$2,574.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $358.71 / $358.71 / $421.12	Professional		$358.71	$358.71	$421.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $624.79 / $624.79 / $624.79	Professional		$624.79	$624.79	$624.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $624.79 / $624.79 / $624.79	Professional		$624.79	$624.79	$624.79
United Facility/Professional Facility Modifier Low / Median / High Price $27.32 / $236.26 / $339.49	Facility		$27.32	$236.26	$339.49
United Facility/Professional Professional Modifier Low / Median / High Price $223.47 / $353.35 / $675.05	Professional		$223.47	$353.35	$675.05