Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.04 / $195.04 / $195.04	Facility		$195.04	$195.04	$195.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.04 / $224.48 / $412.00	Professional		$195.04	$224.48	$412.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $318.17 / $349.99 / $579.07	Facility		$318.17	$349.99	$579.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.89 / $318.17 / $397.71	Professional		$295.89	$318.17	$397.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $412.13 / $680.88 / $680.88	Facility		$412.13	$680.88	$680.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $382.03 / $1,134.14 / $1,525.52	Facility		$382.03	$1,134.14	$1,525.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.88 / $526.82 / $598.66	Professional		$278.88	$526.82	$598.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.22 / $293.97 / $381.80	Facility		$120.22	$293.97	$381.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $165.09 / $318.17 / $381.80	Professional		$165.09	$318.17	$381.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $195.04 / $367.46 / $1,660.98	Facility		$195.04	$367.46	$1,660.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.63 / $303.13 / $547.79	Professional		$257.63	$303.13	$547.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $421.00	Professional		$50.00	$70.00	$421.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $120.22 / $294.83 / $381.80	Facility		$120.22	$294.83	$381.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $165.09 / $318.17 / $381.80	Professional		$165.09	$318.17	$381.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $318.17 / $386.51 / $710.76	Professional		$318.17	$386.51	$710.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $382.03 / $617.82 / $1,660.98	Facility		$382.03	$617.82	$1,660.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $278.88 / $382.03 / $2,581.42	Professional		$278.88	$382.03	$2,581.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $473.84 / $473.84 / $473.84	Professional		$473.84	$473.84	$473.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $473.84 / $473.84 / $473.84	Professional		$473.84	$473.84	$473.84
United Facility/Professional Professional Modifier Low / Median / High Price $202.09 / $286.02 / $482.60	Professional		$202.09	$286.02	$482.60