Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.02 / $223.02 / $223.02	Facility		$223.02	$223.02	$223.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.11 / $184.88 / $247.37	Professional		$143.11	$184.88	$247.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $326.39 / $594.04 / $594.04	Facility		$326.39	$594.04	$594.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.52 / $303.55 / $440.61	Professional		$303.52	$303.55	$440.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.55 / $199.24 / $698.45	Facility		$26.55	$199.24	$698.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $244.43 / $244.43 / $940.03	Facility		$244.43	$244.43	$940.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.43 / $358.88 / $448.59	Professional		$178.43	$358.88	$448.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $224.97 / $295.44 / $424.70	Facility		$224.97	$295.44	$424.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $443.16 / $443.16 / $443.16	Professional		$443.16	$443.16	$443.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $224.97 / $424.70 / $1,550.44	Facility		$224.97	$424.70	$1,550.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.72 / $180.99 / $400.37	Professional		$132.72	$180.99	$400.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $221.13	Professional		$50.00	$65.00	$221.13
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $223.02 / $334.53 / $424.70	Facility		$223.02	$334.53	$424.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $443.16 / $443.16 / $443.16	Professional		$443.16	$443.16	$443.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.08 / $72.56 / $94.23	Professional		$43.08	$72.56	$94.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $244.43 / $633.74 / $1,550.44	Facility		$244.43	$633.74	$1,550.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $207.77 / $244.43 / $244.43	Professional		$207.77	$244.43	$244.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $362.64 / $362.64 / $362.64	Professional		$362.64	$362.64	$362.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $362.64 / $362.64 / $362.64	Professional		$362.64	$362.64	$362.64
United Facility/Professional Professional Modifier Low / Median / High Price $119.98 / $177.84 / $400.23	Professional		$119.98	$177.84	$400.23