Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $435.58 / $819.04 / $940.64	Facility		$435.58	$819.04	$940.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $435.58 / $507.47	Professional		$422.89	$435.58	$507.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $528.61 / $782.35 / $943.04	Facility		$528.61	$782.35	$943.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $422.89 / $570.90	Professional		$422.89	$422.89	$570.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $578.97 / $625.88 / $676.62	Facility		$578.97	$625.88	$676.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $422.89 / $800.67 / $1,388.96	Facility		$422.89	$800.67	$1,388.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $490.81 / $726.73	Professional		$422.89	$490.81	$726.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $409.52 / $422.89 / $467.64	Facility		$409.52	$422.89	$467.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $614.28 / $845.78 / $845.78	Professional		$614.28	$845.78	$845.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $370.82 / $409.52 / $452.86	Facility		$370.82	$409.52	$452.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $409.52 / $455.88 / $1,968.33	Professional		$409.52	$455.88	$1,968.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $275.23 / $422.89 / $467.64	Facility		$275.23	$422.89	$467.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $614.28 / $845.78 / $845.78	Professional		$614.28	$845.78	$845.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $633.96 / $1,236.00	Professional		$422.89	$633.96	$1,236.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $703.90 / $2,045.05 / $2,045.05	Facility		$703.90	$2,045.05	$2,045.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $735.62 / $1,968.33	Professional		$422.89	$735.62	$1,968.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $409.52 / $409.52 / $409.52	Professional		$409.52	$409.52	$409.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $353.53 / $593.74 / $594.61	Professional		$353.53	$593.74	$594.61
United Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $444.03 / $532.84	Professional		$422.89	$444.03	$532.84