Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $337.01 / $337.01 / $337.01	Facility		$337.01	$337.01	$337.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.88 / $301.25 / $401.38	Professional		$213.88	$301.25	$401.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $459.00 / $835.38 / $835.38	Facility		$459.00	$835.38	$835.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.87 / $459.00 / $619.65	Professional		$426.87	$459.00	$619.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.45 / $323.61 / $1,058.64	Facility		$47.45	$323.61	$1,058.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $299.44 / $299.44 / $1,213.81	Facility		$299.44	$299.44	$1,213.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.44 / $526.88 / $658.59	Professional		$299.44	$526.88	$658.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $337.01 / $527.63 / $758.47	Facility		$337.01	$527.63	$758.47
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $438.16 / $438.16 / $791.45	Professional		$438.16	$438.16	$791.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $337.01 / $723.02 / $2,147.32	Facility		$337.01	$723.02	$2,147.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $250.57 / $355.81 / $617.96	Professional		$250.57	$355.81	$617.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $644.08	Professional		$50.00	$58.40	$644.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $337.01 / $527.63 / $758.47	Facility		$337.01	$527.63	$758.47
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $438.16 / $438.16 / $791.45	Professional		$438.16	$438.16	$791.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $97.81 / $127.00	Professional		$60.59	$97.81	$127.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $299.44 / $891.30 / $2,147.32	Facility		$299.44	$891.30	$2,147.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $299.44 / $299.44 / $400.87	Professional		$299.44	$299.44	$400.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $576.12 / $576.12 / $576.12	Professional		$576.12	$576.12	$576.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $576.12 / $576.12 / $576.12	Professional		$576.12	$576.12	$576.12
United Facility/Professional Professional Modifier Low / Median / High Price $235.28 / $352.98 / $609.82	Professional		$235.28	$352.98	$609.82