Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.38 / $257.38 / $257.38	Facility		$257.38	$257.38	$257.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.75 / $231.64 / $303.61	Professional		$161.75	$231.64	$303.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $384.70 / $700.15 / $700.15	Facility		$384.70	$700.15	$700.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $357.72 / $357.77 / $519.27	Professional		$357.72	$357.77	$519.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.95 / $217.15 / $823.15	Facility		$28.95	$217.15	$823.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $267.62 / $267.62 / $1,028.18	Facility		$267.62	$267.62	$1,028.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.62 / $445.88 / $557.34	Professional		$267.62	$445.88	$557.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $280.08 / $386.07 / $463.28	Facility		$280.08	$386.07	$463.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $482.94 / $482.94 / $482.94	Professional		$482.94	$482.94	$482.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $280.08 / $463.28 / $1,807.28	Facility		$280.08	$463.28	$1,807.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.82 / $228.84 / $482.94	Professional		$167.82	$228.84	$482.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $320.30	Professional		$50.00	$65.00	$320.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $280.08 / $386.07 / $463.28	Facility		$280.08	$386.07	$463.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $482.94 / $482.94 / $482.94	Professional		$482.94	$482.94	$482.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.78 / $93.87 / $121.88	Professional		$50.78	$93.87	$121.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $267.62 / $746.90 / $1,807.28	Facility		$267.62	$746.90	$1,807.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $267.62 / $267.62 / $330.59	Professional		$267.62	$267.62	$330.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $393.55 / $393.55 / $393.55	Professional		$393.55	$393.55	$393.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $393.55 / $393.55 / $393.55	Professional		$393.55	$393.55	$393.55
United Facility/Professional Professional Modifier Low / Median / High Price $149.38 / $223.10 / $393.55	Professional		$149.38	$223.10	$393.55