Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.02 / $296.17 / $296.17	Facility		$166.02	$296.17	$296.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $404.00 / $667.79	Professional		$136.00	$404.00	$667.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $496.23 / $545.85 / $903.14	Facility		$496.23	$545.85	$903.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $461.49 / $461.49 / $620.28	Professional		$461.49	$461.49	$620.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $496.23 / $597.04 / $1,061.93	Facility		$496.23	$597.04	$1,061.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $496.23 / $521.04 / $758.35	Professional		$496.23	$521.04	$758.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $465.67 / $1,642.58 / $2,027.97	Facility		$465.67	$1,642.58	$2,027.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.94 / $719.61 / $933.69	Professional		$339.94	$719.61	$933.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $296.17 / $444.26 / $595.48	Facility		$296.17	$444.26	$595.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $443.19 / $496.23 / $595.48	Professional		$443.19	$496.23	$595.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $318.52 / $533.11 / $2,424.52	Facility		$318.52	$533.11	$2,424.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $341.71 / $457.26 / $711.77	Professional		$341.71	$457.26	$711.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $267.14	Professional		$50.00	$70.00	$267.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $296.17 / $444.26 / $595.48	Facility		$296.17	$444.26	$595.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $443.19 / $496.23 / $595.48	Professional		$443.19	$496.23	$595.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $496.23 / $1,006.24 / $1,318.86	Professional		$496.23	$1,006.24	$1,318.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $465.67 / $963.56 / $2,424.52	Facility		$465.67	$963.56	$2,424.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $339.94 / $465.67 / $3,450.30	Professional		$339.94	$465.67	$3,450.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $685.80 / $685.80 / $685.80	Professional		$685.80	$685.80	$685.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $685.80 / $685.80 / $685.80	Professional		$685.80	$685.80	$685.80
United Facility/Professional Professional Modifier Low / Median / High Price $241.24 / $414.04 / $855.63	Professional		$241.24	$414.04	$855.63