Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $255.95 / $497.00 / $570.77	Facility		$255.95	$497.00	$570.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $250.98 / $298.20	Professional		$248.50	$250.98	$298.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $310.63 / $459.73 / $554.16	Facility		$310.63	$459.73	$554.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $248.50 / $335.47	Professional		$248.50	$248.50	$335.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $397.60 / $447.30 / $455.48	Facility		$397.60	$447.30	$455.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $248.50 / $477.82 / $828.90	Facility		$248.50	$477.82	$828.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $310.27 / $459.78	Professional		$248.50	$310.27	$459.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $248.50 / $248.50 / $274.79	Facility		$248.50	$248.50	$274.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $372.75 / $497.00 / $497.00	Professional		$372.75	$497.00	$497.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $248.50 / $248.50 / $276.08	Facility		$248.50	$248.50	$276.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $276.63 / $1,074.29	Professional		$248.50	$276.63	$1,074.29
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 $248.50 / $248.50 / $274.79	Facility		$248.50	$248.50	$274.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $372.75 / $497.00 / $497.00	Professional		$372.75	$497.00	$497.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $323.20 / $827.20	Professional		$248.50	$323.20	$827.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $243.63 / $248.50 / $1,218.15	Facility		$243.63	$248.50	$1,218.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $447.62 / $1,074.29	Professional		$248.50	$447.62	$1,074.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $298.69 / $348.89 / $348.89	Professional		$298.69	$348.89	$348.89
United Facility/Professional Facility Modifier Low / Median / High Price $248.34 / $248.34 / $248.34	Facility		$248.34	$248.34	$248.34
United Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $255.98 / $295.72	Professional		$248.50	$255.98	$295.72