Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.71 / $148.71 / $148.71	Facility		$148.71	$148.71	$148.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.99 / $148.71 / $265.86	Professional		$139.99	$148.71	$265.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.77 / $324.26 / $536.50	Facility		$294.77	$324.26	$536.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.30 / $274.14 / $362.57	Professional		$265.30	$274.14	$362.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $212.07 / $630.83 / $630.83	Facility		$212.07	$630.83	$630.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.69 / $609.76 / $1,230.22	Facility		$190.69	$609.76	$1,230.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $427.03 / $557.89	Professional		$139.19	$427.03	$557.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $94.94 / $223.07 / $339.00	Facility		$94.94	$223.07	$339.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $168.78 / $294.77 / $393.04	Professional		$168.78	$294.77	$393.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $148.71 / $291.92 / $1,539.25	Facility		$148.71	$291.92	$1,539.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $133.54 / $171.58 / $332.81	Professional		$133.54	$171.58	$332.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $312.66	Professional		$50.00	$70.00	$312.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $94.94 / $223.07 / $339.00	Facility		$94.94	$223.07	$339.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $168.78 / $294.77 / $393.04	Professional		$168.78	$294.77	$393.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $294.77 / $453.67 / $882.25	Professional		$294.77	$453.67	$882.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $190.69 / $575.74 / $1,539.25	Facility		$190.69	$575.74	$1,539.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $190.69 / $1,957.34	Professional		$139.19	$190.69	$1,957.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $294.77 / $294.77 / $294.77	Professional		$294.77	$294.77	$294.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $235.37 / $294.77 / $294.77	Professional		$235.37	$294.77	$294.77
United Facility/Professional Professional Modifier Low / Median / High Price $117.44 / $147.30 / $281.88	Professional		$117.44	$147.30	$281.88