Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $226.82 / $226.82 / $226.82	Facility		$226.82	$226.82	$226.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.60 / $226.82 / $388.57	Professional		$204.60	$226.82	$388.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $449.64 / $494.60 / $818.34	Facility		$449.64	$494.60	$818.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $404.67 / $418.17 / $553.04	Professional		$404.67	$418.17	$553.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $323.45 / $962.23 / $962.23	Facility		$323.45	$962.23	$962.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.20 / $929.65 / $1,876.82	Facility		$253.20	$929.65	$1,876.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.84 / $651.55 / $850.98	Professional		$184.84	$651.55	$850.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $130.51 / $340.23 / $517.09	Facility		$130.51	$340.23	$517.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $449.64 / $540.29	Professional		$257.45	$449.64	$540.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $225.91 / $449.64 / $2,141.94	Facility		$225.91	$449.64	$2,141.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.10 / $235.85 / $505.40	Professional		$187.10	$235.85	$505.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $249.37	Professional		$50.00	$70.00	$249.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $130.51 / $340.23 / $517.09	Facility		$130.51	$340.23	$517.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $449.64 / $540.29	Professional		$257.45	$449.64	$540.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $449.64 / $691.98 / $1,213.47	Professional		$449.64	$691.98	$1,213.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $253.20 / $878.20 / $2,141.94	Facility		$253.20	$878.20	$2,141.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $184.84 / $253.20 / $2,668.05	Professional		$184.84	$253.20	$2,668.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $449.64 / $449.64 / $449.64	Professional		$449.64	$449.64	$449.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $449.64 / $449.64 / $449.64	Professional		$449.64	$449.64	$449.64
United Facility/Professional Professional Modifier Low / Median / High Price $158.29 / $224.32 / $432.23	Professional		$158.29	$224.32	$432.23