Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.34 / $412.26 / $473.45	Facility		$213.34	$412.26	$473.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $209.20 / $240.27	Professional		$207.13	$209.20	$240.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.91 / $383.19 / $461.90	Facility		$258.91	$383.19	$461.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $279.62	Professional		$207.13	$207.13	$279.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $331.41 / $372.83 / $379.65	Facility		$331.41	$372.83	$379.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $407.29 / $706.55	Facility		$207.13	$407.29	$706.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $261.14 / $354.46	Professional		$207.13	$261.14	$354.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $206.13 / $207.13 / $232.72	Facility		$206.13	$207.13	$232.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $309.20 / $414.26 / $414.26	Professional		$309.20	$414.26	$414.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $206.13 / $206.13 / $227.94	Facility		$206.13	$206.13	$227.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $206.13 / $229.47 / $904.64	Professional		$206.13	$229.47	$904.64
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 $206.13 / $207.13 / $230.53	Facility		$206.13	$207.13	$230.53
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $309.20 / $414.26 / $414.26	Professional		$309.20	$414.26	$414.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $207.12 / $317.81 / $684.02	Professional		$207.12	$317.81	$684.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $206.81 / $207.13 / $1,025.20	Facility		$206.81	$207.13	$1,025.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $376.94 / $904.64	Professional		$207.13	$376.94	$904.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $290.81 / $290.81 / $290.81	Professional		$290.81	$290.81	$290.81
United Facility/Professional Facility Modifier Low / Median / High Price $207.00 / $207.00 / $207.00	Facility		$207.00	$207.00	$207.00
United Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $219.56 / $247.50	Professional		$207.13	$219.56	$247.50