Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.80 / $210.80 / $210.80	Facility		$210.80	$210.80	$210.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.52 / $210.80 / $378.92	Professional		$199.52	$210.80	$378.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $417.86 / $459.65 / $760.51	Facility		$417.86	$459.65	$760.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $376.07 / $388.61 / $513.96	Professional		$376.07	$388.61	$513.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $300.62 / $894.22 / $894.22	Facility		$300.62	$894.22	$894.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $233.26 / $922.69 / $1,743.86	Facility		$233.26	$922.69	$1,743.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.28 / $695.94 / $790.84	Professional		$170.28	$695.94	$790.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $316.20 / $480.54	Facility		$120.23	$316.20	$480.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $239.26 / $407.85 / $501.43	Professional		$239.26	$407.85	$501.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.12 / $417.86 / $1,945.90	Facility		$208.12	$417.86	$1,945.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $182.47 / $218.89 / $455.00	Professional		$182.47	$218.89	$455.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $347.99	Professional		$50.00	$70.00	$347.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $316.20 / $480.54	Facility		$120.23	$316.20	$480.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $239.26 / $407.85 / $501.43	Professional		$239.26	$407.85	$501.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $417.86 / $643.10 / $1,117.11	Professional		$417.86	$643.10	$1,117.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $233.26 / $816.14 / $1,945.90	Facility		$233.26	$816.14	$1,945.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $170.28 / $233.26 / $2,103.75	Professional		$170.28	$233.26	$2,103.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $417.86 / $417.86 / $417.86	Professional		$417.86	$417.86	$417.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $417.86 / $417.86 / $417.86	Professional		$417.86	$417.86	$417.86
United Facility/Professional Professional Modifier Low / Median / High Price $155.19 / $208.47 / $398.18	Professional		$155.19	$208.47	$398.18