Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.74 / $144.74 / $144.74	Facility		$144.74	$144.74	$144.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.53 / $144.74 / $225.11	Professional		$118.53	$144.74	$225.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $286.92 / $315.61 / $522.19	Facility		$286.92	$315.61	$522.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $240.15 / $266.83 / $352.91	Professional		$240.15	$266.83	$352.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $206.41 / $614.01 / $614.01	Facility		$206.41	$614.01	$614.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.61 / $592.87 / $1,198.03	Facility		$185.61	$592.87	$1,198.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.50 / $415.78 / $543.03	Professional		$135.50	$415.78	$543.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $80.38 / $217.11 / $329.96	Facility		$80.38	$217.11	$329.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $164.29 / $286.92 / $344.30	Professional		$164.29	$286.92	$344.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.15 / $286.92 / $1,347.14	Facility		$139.15	$286.92	$1,347.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $148.11 / $312.43	Professional		$115.13	$148.11	$312.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $143.41	Professional		$50.00	$70.00	$143.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $80.38 / $217.11 / $329.96	Facility		$80.38	$217.11	$329.96
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $164.29 / $286.92 / $344.30	Professional		$164.29	$286.92	$344.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $286.92 / $441.55 / $746.75	Professional		$286.92	$441.55	$746.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $185.61 / $560.40 / $1,347.14	Facility		$185.61	$560.40	$1,347.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.50 / $185.61 / $1,673.42	Professional		$135.50	$185.61	$1,673.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $286.92 / $286.92 / $286.92	Professional		$286.92	$286.92	$286.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $229.11 / $286.92 / $286.92	Professional		$229.11	$286.92	$286.92
United Facility/Professional Facility Modifier Low / Median / High Price $195.26 / $195.26 / $195.26	Facility		$195.26	$195.26	$195.26
United Facility/Professional Professional Modifier Low / Median / High Price $97.50 / $143.13 / $266.23	Professional		$97.50	$143.13	$266.23