Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.10 / $454.20 / $521.62	Facility		$234.10	$454.20	$521.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.28 / $229.55 / $274.79	Professional		$227.28	$229.55	$274.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $284.10 / $420.47 / $506.83	Facility		$284.10	$420.47	$506.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.28 / $227.28 / $306.82	Professional		$227.28	$227.28	$306.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $363.65 / $409.10 / $416.58	Facility		$363.65	$409.10	$416.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $227.28 / $329.19 / $602.21	Facility		$227.28	$329.19	$602.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.28 / $282.38 / $413.21	Professional		$227.28	$282.38	$413.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $194.51 / $227.28 / $391.57	Facility		$194.51	$227.28	$391.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $340.65 / $454.56 / $454.56	Professional		$340.65	$454.56	$454.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $194.51 / $227.10 / $317.94	Facility		$194.51	$227.10	$317.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $227.10 / $252.81 / $9,490.31	Professional		$227.10	$252.81	$9,490.31
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 $173.67 / $227.28 / $391.57	Facility		$173.67	$227.28	$391.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $340.65 / $454.56 / $454.56	Professional		$340.65	$454.56	$454.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $227.27 / $313.55 / $693.00	Professional		$227.27	$313.55	$693.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $227.28 / $227.28 / $1,108.55	Facility		$227.28	$227.28	$1,108.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $227.28 / $412.25 / $9,490.31	Professional		$227.28	$412.25	$9,490.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $210.39 / $319.10 / $319.10	Professional		$210.39	$319.10	$319.10
United Facility/Professional Facility Modifier Low / Median / High Price $221.71 / $221.71 / $476.68	Facility		$221.71	$221.71	$476.68
United Facility/Professional Professional Modifier Low / Median / High Price $227.28 / $240.36 / $291.48	Professional		$227.28	$240.36	$291.48