Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.64 / $202.64 / $202.64	Facility		$202.64	$202.64	$202.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.76 / $202.64 / $362.29	Professional		$190.76	$202.64	$362.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $401.69 / $441.86 / $731.08	Facility		$401.69	$441.86	$731.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.52 / $373.57 / $494.07	Professional		$361.52	$373.57	$494.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $288.98 / $859.62 / $859.62	Facility		$288.98	$859.62	$859.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.00 / $830.21 / $1,676.68	Facility		$251.00	$830.21	$1,676.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.23 / $582.19 / $760.24	Professional		$183.23	$582.19	$760.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $129.38 / $303.95 / $461.94	Facility		$129.38	$303.95	$461.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $230.00 / $401.69 / $535.59	Professional		$230.00	$401.69	$535.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $202.64 / $401.69 / $2,126.12	Facility		$202.64	$401.69	$2,126.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.96 / $238.37 / $453.50	Professional		$181.96	$238.37	$453.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $307.61	Professional		$50.00	$70.00	$307.61
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $129.38 / $303.95 / $461.94	Facility		$129.38	$303.95	$461.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $230.00 / $401.69 / $535.59	Professional		$230.00	$401.69	$535.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $401.69 / $618.20 / $1,202.43	Professional		$401.69	$618.20	$1,202.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $251.00 / $784.56 / $2,126.12	Facility		$251.00	$784.56	$2,126.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $183.23 / $251.00 / $2,960.55	Professional		$183.23	$251.00	$2,960.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $401.69 / $401.69 / $401.69	Professional		$401.69	$401.69	$401.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $401.69 / $401.69 / $401.69	Professional		$401.69	$401.69	$401.69
United Facility/Professional Facility Modifier Low / Median / High Price $345.78 / $345.78 / $345.78	Facility		$345.78	$345.78	$345.78
United Facility/Professional Professional Modifier Low / Median / High Price $160.03 / $203.09 / $375.40	Professional		$160.03	$203.09	$375.40