Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.02 / $153.02 / $153.02	Facility		$153.02	$153.02	$153.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.60 / $153.02 / $278.43	Professional		$146.60	$153.02	$278.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $303.33 / $333.66 / $552.05	Facility		$303.33	$333.66	$552.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $272.99 / $282.10 / $373.09	Professional		$272.99	$282.10	$373.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.22 / $649.13 / $649.13	Facility		$218.22	$649.13	$649.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $196.21 / $626.65 / $1,266.60	Facility		$196.21	$626.65	$1,266.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.22 / $439.69 / $574.08	Professional		$143.22	$439.69	$574.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $97.69 / $229.53 / $348.83	Facility		$97.69	$229.53	$348.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $173.67 / $303.33 / $404.43	Professional		$173.67	$303.33	$404.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $153.02 / $317.68 / $1,587.88	Facility		$153.02	$317.68	$1,587.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.40 / $176.55 / $342.45	Professional		$137.40	$176.55	$342.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $152.90	Professional		$50.00	$70.00	$152.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $97.69 / $229.53 / $348.83	Facility		$97.69	$229.53	$348.83
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $173.67 / $303.33 / $404.43	Professional		$173.67	$303.33	$404.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $303.33 / $466.81 / $908.35	Professional		$303.33	$466.81	$908.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $196.21 / $592.44 / $1,587.88	Facility		$196.21	$592.44	$1,587.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $143.22 / $196.21 / $2,590.42	Professional		$143.22	$196.21	$2,590.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $303.33 / $303.33 / $303.33	Professional		$303.33	$303.33	$303.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $303.33 / $303.33 / $303.33	Professional		$303.33	$303.33	$303.33
United Facility/Professional Professional Modifier Low / Median / High Price $126.11 / $158.88 / $303.33	Professional		$126.11	$158.88	$303.33