Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.92 / $391.58 / $1,085.92	Facility		$187.92	$391.58	$1,085.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $336.37 / $554.89	Professional		$182.45	$336.37	$554.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $228.06 / $337.53 / $406.86	Facility		$228.06	$337.53	$406.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $231.71	Professional		$182.45	$182.45	$231.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $249.79 / $249.79 / $291.92	Facility		$249.79	$249.79	$291.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.45 / $466.85 / $667.34	Facility		$182.45	$466.85	$667.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $293.77 / $333.84	Professional		$182.45	$293.77	$333.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $182.45 / $195.79 / $402.05	Facility		$182.45	$195.79	$402.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $51.30 / $364.90 / $364.90	Professional		$51.30	$364.90	$364.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $195.79 / $202.03 / $631.67	Facility		$195.79	$202.03	$631.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $195.79 / $195.79 / $364.90	Professional		$195.79	$195.79	$364.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $190.76	Professional		$65.00	$85.00	$190.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $182.45 / $195.79 / $402.05	Facility		$182.45	$195.79	$402.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $51.30 / $364.90 / $364.90	Professional		$51.30	$364.90	$364.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $284.00 / $569.00	Professional		$182.45	$284.00	$569.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $182.45 / $182.45 / $1,058.95	Facility		$182.45	$182.45	$1,058.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $182.45	Professional		$182.45	$182.45	$182.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $233.67 / $256.16 / $289.18	Professional		$233.67	$256.16	$289.18
United Facility/Professional Facility Modifier Low / Median / High Price $182.33 / $182.33 / $182.33	Facility		$182.33	$182.33	$182.33
United Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $273.68	Professional		$182.45	$182.45	$273.68