Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $391.59 / $741.35 / $873.25	Facility		$391.59	$741.35	$873.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $392.80 / $906.91	Professional		$381.36	$392.80	$906.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $476.70 / $705.52 / $850.43	Facility		$476.70	$705.52	$850.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $381.36 / $484.32	Professional		$381.36	$381.36	$484.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $522.11 / $522.11 / $610.17	Facility		$522.11	$522.11	$610.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $381.36 / $485.68 / $1,029.94	Facility		$381.36	$485.68	$1,029.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.41 / $573.00 / $651.14	Professional		$381.41	$573.00	$651.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $317.62 / $380.18 / $840.44	Facility		$317.62	$380.18	$840.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $570.27 / $762.72 / $762.72	Professional		$570.27	$762.72	$762.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $317.62 / $380.18 / $837.58	Facility		$317.62	$380.18	$837.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.18 / $380.18 / $762.72	Professional		$380.18	$380.18	$762.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $374.36	Professional		$65.00	$85.00	$374.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $317.62 / $380.18 / $840.44	Facility		$317.62	$380.18	$840.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $570.27 / $762.72 / $762.72	Professional		$570.27	$762.72	$762.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $580.26 / $1,156.00	Professional		$381.36	$580.26	$1,156.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $381.36 / $381.36 / $1,871.80	Facility		$381.36	$381.36	$1,871.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $381.36 / $381.36	Professional		$381.36	$381.36	$381.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $432.03 / $535.42 / $556.16	Professional		$432.03	$535.42	$556.16
United Facility/Professional Facility Modifier Low / Median / High Price $374.36 / $374.36 / $876.00	Facility		$374.36	$374.36	$876.00
United Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $381.36 / $522.16	Professional		$381.36	$381.36	$522.16