Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $231.86 / $439.12 / $517.25	Facility		$231.86	$439.12	$517.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.11 / $231.86 / $592.85	Professional		$225.11	$231.86	$592.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.39 / $416.45 / $502.00	Facility		$281.39	$416.45	$502.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.11 / $225.11 / $285.88	Professional		$225.11	$225.11	$285.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $308.20 / $308.20 / $360.18	Facility		$308.20	$308.20	$360.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.11 / $263.75 / $614.20	Facility		$225.11	$263.75	$614.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.11 / $345.87 / $393.04	Professional		$225.11	$345.87	$393.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $225.11 / $225.19 / $496.13	Facility		$225.11	$225.19	$496.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $337.79 / $450.22 / $450.22	Professional		$337.79	$450.22	$450.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $225.19 / $225.19 / $496.13	Facility		$225.19	$225.19	$496.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $225.19 / $225.19 / $450.22	Professional		$225.19	$225.19	$450.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $220.32	Professional		$65.00	$85.00	$220.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $225.11 / $225.19 / $496.13	Facility		$225.11	$225.19	$496.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $337.79 / $450.22 / $450.22	Professional		$337.79	$450.22	$450.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $225.11 / $238.62 / $750.20	Professional		$225.11	$238.62	$750.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,131.40 / $1,131.40 / $1,131.40	Facility		$1,131.40	$1,131.40	$1,131.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $225.11 / $225.11 / $225.11	Professional		$225.11	$225.11	$225.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $316.05 / $316.05 / $378.91	Professional		$316.05	$316.05	$378.91
United Facility/Professional Facility Modifier Low / Median / High Price $224.97 / $224.97 / $224.97	Facility		$224.97	$224.97	$224.97
United Facility/Professional Professional Modifier Low / Median / High Price $225.11 / $225.11 / $308.22	Professional		$225.11	$225.11	$308.22