Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $230.60 / $230.60 / $230.60	Facility		$230.60	$230.60	$230.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.88 / $230.60 / $417.59	Professional		$219.88	$230.60	$417.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $457.12 / $502.83 / $831.96	Facility		$457.12	$502.83	$831.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $411.40 / $425.12 / $562.25	Professional		$411.40	$425.12	$562.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $328.86 / $978.24 / $978.24	Facility		$328.86	$978.24	$978.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.70 / $1,008.84 / $1,907.61	Facility		$295.70	$1,008.84	$1,907.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.87 / $662.34 / $865.14	Professional		$215.87	$662.34	$865.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $135.56 / $345.90 / $525.69	Facility		$135.56	$345.90	$525.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $261.74 / $457.12 / $561.21	Professional		$261.74	$457.12	$561.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $230.60 / $457.12 / $2,182.33	Facility		$230.60	$457.12	$2,182.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $201.10 / $244.99 / $516.08	Professional		$201.10	$244.99	$516.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $308.49	Professional		$50.00	$65.00	$308.49
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $135.56 / $345.90 / $525.69	Facility		$135.56	$345.90	$525.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $261.74 / $457.12 / $561.21	Professional		$261.74	$457.12	$561.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $457.12 / $703.51 / $1,259.64	Professional		$457.12	$703.51	$1,259.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $295.70 / $892.82 / $2,182.33	Facility		$295.70	$892.82	$2,182.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $215.87 / $295.70 / $2,693.81	Professional		$215.87	$295.70	$2,693.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $457.12 / $457.12 / $457.12	Professional		$457.12	$457.12	$457.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $457.12 / $457.12 / $457.12	Professional		$457.12	$457.12	$457.12
United Facility/Professional Facility Modifier Low / Median / High Price $0.34 / $208.12 / $244.99	Facility		$0.34	$208.12	$244.99
United Facility/Professional Professional Modifier Low / Median / High Price $174.99 / $242.69 / $437.12	Professional		$174.99	$242.69	$437.12