Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.61 / $347.28 / $398.84	Facility		$245.61	$347.28	$398.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $245.61 / $298.31	Professional		$238.46	$245.61	$298.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $298.08 / $441.15 / $531.77	Facility		$298.08	$441.15	$531.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $238.46 / $321.92	Professional		$238.46	$238.46	$321.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $381.54 / $429.23 / $437.07	Facility		$381.54	$429.23	$437.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $238.46 / $442.83 / $920.58	Facility		$238.46	$442.83	$920.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.25 / $238.46 / $533.01	Professional		$157.25	$238.46	$533.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $173.64 / $245.61 / $3,724.01	Facility		$173.64	$245.61	$3,724.01
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $107.96 / $476.92 / $476.92	Professional		$107.96	$476.92	$476.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.64 / $178.85 / $3,724.01	Facility		$173.64	$178.85	$3,724.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.64 / $193.30 / $16,586.83	Professional		$173.64	$193.30	$16,586.83
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 $173.64 / $245.61 / $3,724.01	Facility		$173.64	$245.61	$3,724.01
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $107.96 / $476.92 / $476.92	Professional		$107.96	$476.92	$476.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $315.60 / $895.99	Professional		$238.46	$315.60	$895.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $238.46 / $765.00 / $10,081.35	Facility		$238.46	$765.00	$10,081.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $2,016.27 / $16,586.83	Professional		$238.46	$2,016.27	$16,586.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $334.80 / $334.80 / $6,409.29	Professional		$334.80	$334.80	$6,409.29
United Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $252.77 / $301.69	Professional		$238.46	$252.77	$301.69