Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.12 / $153.12 / $153.12	Facility		$153.12	$153.12	$153.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.56 / $160.06 / $210.90	Professional		$126.56	$160.06	$210.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $303.52 / $333.88 / $552.41	Facility		$303.52	$333.88	$552.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $262.52 / $282.27 / $373.34	Professional		$262.52	$282.27	$373.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.37 / $649.54 / $649.54	Facility		$218.37	$649.54	$649.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.81 / $627.57 / $1,266.60	Facility		$175.81	$627.57	$1,266.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.34 / $439.69 / $574.46	Professional		$128.34	$439.69	$574.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.84 / $228.15 / $349.06	Facility		$85.84	$228.15	$349.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $173.81 / $303.52 / $364.24	Professional		$173.81	$303.52	$364.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $148.58 / $303.52 / $1,417.95	Facility		$148.58	$303.52	$1,417.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.93 / $158.15 / $332.40	Professional		$122.93	$158.15	$332.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $169.57	Professional		$50.00	$70.00	$169.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $85.84 / $229.68 / $349.06	Facility		$85.84	$229.68	$349.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $173.81 / $303.52 / $364.24	Professional		$173.81	$303.52	$364.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $303.52 / $467.16 / $797.94	Professional		$303.52	$467.16	$797.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $175.81 / $592.84 / $1,417.95	Facility		$175.81	$592.84	$1,417.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.34 / $175.81 / $1,852.79	Professional		$128.34	$175.81	$1,852.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $303.52 / $303.52 / $303.52	Professional		$303.52	$303.52	$303.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $242.38 / $303.52 / $303.52	Professional		$242.38	$303.52	$303.52
United Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $151.43 / $330.51	Professional		$104.10	$151.43	$330.51