Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.86 / $170.86 / $170.86	Facility		$170.86	$170.86	$170.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.58 / $170.86 / $235.33	Professional		$123.58	$170.86	$235.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.69 / $372.56 / $616.41	Facility		$338.69	$372.56	$616.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $292.93 / $314.98 / $416.58	Professional		$292.93	$314.98	$416.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $243.66 / $724.80 / $724.80	Facility		$243.66	$724.80	$724.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.91 / $699.82 / $1,413.56	Facility		$159.91	$699.82	$1,413.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.74 / $564.07 / $640.99	Professional		$116.74	$564.07	$640.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $82.43 / $256.29 / $389.49	Facility		$82.43	$256.29	$389.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $193.93 / $338.69 / $406.43	Professional		$193.93	$338.69	$406.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $142.69 / $338.69 / $1,399.37	Facility		$142.69	$338.69	$1,399.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $127.68 / $168.97 / $368.79	Professional		$127.68	$168.97	$368.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $186.59	Professional		$50.00	$70.00	$186.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $82.43 / $256.29 / $389.49	Facility		$82.43	$256.29	$389.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $193.93 / $338.69 / $406.43	Professional		$193.93	$338.69	$406.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $338.69 / $508.04 / $765.82	Professional		$338.69	$508.04	$765.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $159.91 / $661.50 / $1,399.37	Facility		$159.91	$661.50	$1,399.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $116.74 / $159.91 / $1,867.14	Professional		$116.74	$159.91	$1,867.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $338.69 / $338.69 / $338.69	Professional		$338.69	$338.69	$338.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $338.69 / $338.69 / $338.69	Professional		$338.69	$338.69	$338.69
United Facility/Professional Professional Modifier Low / Median / High Price $112.65 / $168.97 / $300.29	Professional		$112.65	$168.97	$300.29