Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.87 / $129.87 / $129.87	Facility		$129.87	$129.87	$129.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.87 / $140.13 / $256.79	Professional		$129.87	$140.13	$256.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $224.35 / $246.79 / $408.32	Facility		$224.35	$246.79	$408.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.65 / $208.65 / $275.95	Professional		$208.65	$208.65	$275.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $246.93 / $480.11 / $480.11	Facility		$246.93	$480.11	$480.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $214.95 / $709.18 / $916.71	Facility		$214.95	$709.18	$916.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.91 / $325.27 / $422.11	Professional		$156.91	$325.27	$422.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.44 / $194.81 / $269.22	Facility		$104.44	$194.81	$269.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $196.54 / $200.37 / $269.22	Professional		$196.54	$200.37	$269.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $129.87 / $258.00 / $1,096.95	Facility		$129.87	$258.00	$1,096.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $149.58 / $188.74 / $303.05	Professional		$149.58	$188.74	$303.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $218.82	Professional		$50.00	$70.00	$218.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $104.44 / $215.30 / $269.22	Facility		$104.44	$215.30	$269.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $196.54 / $200.37 / $269.22	Professional		$196.54	$200.37	$269.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $224.35 / $441.11 / $596.20	Professional		$224.35	$441.11	$596.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $214.95 / $435.62 / $1,096.95	Facility		$214.95	$435.62	$1,096.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $156.91 / $214.95 / $1,674.36	Professional		$156.91	$214.95	$1,674.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $294.07 / $294.07 / $294.07	Professional		$294.07	$294.07	$294.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $274.08 / $294.07 / $322.45	Professional		$274.08	$294.07	$322.45
United Facility/Professional Professional Modifier Low / Median / High Price $136.75 / $176.44 / $294.39	Professional		$136.75	$176.44	$294.39