Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.88 / $149.88 / $149.88	Facility		$149.88	$149.88	$149.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.91 / $152.80 / $206.46	Professional		$130.91	$152.80	$206.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $297.13 / $326.83 / $540.78	Facility		$297.13	$326.83	$540.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.41 / $276.33 / $365.46	Professional		$267.41	$276.33	$365.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $213.76 / $635.86 / $635.86	Facility		$213.76	$635.86	$635.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.78 / $614.45 / $1,240.01	Facility		$190.78	$614.45	$1,240.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.27 / $430.78 / $562.35	Professional		$139.27	$430.78	$562.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.01 / $224.84 / $341.70	Facility		$84.01	$224.84	$341.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $170.13 / $297.13 / $356.56	Professional		$170.13	$297.13	$356.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $145.41 / $297.13 / $1,353.88	Facility		$145.41	$297.13	$1,353.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.31 / $154.79 / $323.55	Professional		$120.31	$154.79	$323.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $182.42	Professional		$50.00	$70.00	$182.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $84.01 / $224.84 / $341.70	Facility		$84.01	$224.84	$341.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $170.13 / $297.13 / $356.56	Professional		$170.13	$297.13	$356.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $297.13 / $457.27 / $780.88	Professional		$297.13	$457.27	$780.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $190.78 / $580.34 / $1,353.88	Facility		$190.78	$580.34	$1,353.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.27 / $190.78 / $1,463.77	Professional		$139.27	$190.78	$1,463.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $297.13 / $297.13 / $297.13	Professional		$297.13	$297.13	$297.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $237.24 / $297.13 / $297.13	Professional		$237.24	$297.13	$297.13
United Facility/Professional Professional Modifier Low / Median / High Price $108.45 / $148.24 / $263.45	Professional		$108.45	$148.24	$263.45