Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $356.49 / $675.07 / $795.17	Facility		$356.49	$675.07	$795.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.11 / $356.49 / $817.41	Professional		$346.11	$356.49	$817.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $432.64 / $640.29 / $771.83	Facility		$432.64	$640.29	$771.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.11 / $346.11 / $439.55	Professional		$346.11	$346.11	$439.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $473.86 / $473.86 / $553.78	Facility		$473.86	$473.86	$553.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $346.11 / $807.37 / $1,154.08	Facility		$346.11	$807.37	$1,154.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.39 / $507.24 / $576.41	Professional		$346.39	$507.24	$576.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $346.11 / $346.19 / $762.73	Facility		$346.11	$346.19	$762.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $519.29 / $692.22 / $692.22	Professional		$519.29	$692.22	$692.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $346.19 / $346.19 / $762.73	Facility		$346.19	$346.19	$762.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.19 / $346.19 / $692.22	Professional		$346.19	$346.19	$692.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $339.99	Professional		$65.00	$85.00	$339.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $346.11 / $346.19 / $762.73	Facility		$346.11	$346.19	$762.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $519.29 / $692.22 / $692.22	Professional		$519.29	$692.22	$692.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $346.11 / $450.43 / $1,152.80	Professional		$346.11	$450.43	$1,152.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,699.95 / $1,699.95 / $1,699.95	Facility		$1,699.95	$1,699.95	$1,699.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $346.11 / $346.11 / $346.11	Professional		$346.11	$346.11	$346.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $472.37 / $485.94 / $521.54	Professional		$472.37	$485.94	$521.54
United Facility/Professional Facility Modifier Low / Median / High Price $346.11 / $346.11 / $346.11	Facility		$346.11	$346.11	$346.11
United Facility/Professional Professional Modifier Low / Median / High Price $346.11 / $346.11 / $473.89	Professional		$346.11	$346.11	$473.89