Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.20 / $190.20 / $190.20	Facility		$190.20	$190.20	$190.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.78 / $190.20 / $320.55	Professional		$168.78	$190.20	$320.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $377.04 / $414.74 / $686.21	Facility		$377.04	$414.74	$686.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $339.33 / $350.65 / $463.75	Professional		$339.33	$350.65	$463.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $271.24 / $806.87 / $806.87	Facility		$271.24	$806.87	$806.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.89 / $779.54 / $1,573.11	Facility		$243.89	$779.54	$1,573.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.04 / $627.95 / $713.58	Professional		$178.04	$627.95	$713.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $114.47 / $285.30 / $433.60	Facility		$114.47	$285.30	$433.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $215.88 / $377.04 / $473.89	Professional		$215.88	$377.04	$473.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $190.20 / $377.04 / $1,827.68	Facility		$190.20	$377.04	$1,827.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $163.94 / $206.86 / $425.67	Professional		$163.94	$206.86	$425.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $276.27	Professional		$50.00	$70.00	$276.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $114.47 / $285.30 / $433.60	Facility		$114.47	$285.30	$433.60
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $215.88 / $377.04 / $473.89	Professional		$215.88	$377.04	$473.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $377.04 / $580.25 / $1,063.92	Professional		$377.04	$580.25	$1,063.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $243.89 / $736.40 / $1,827.68	Facility		$243.89	$736.40	$1,827.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $178.04 / $243.89 / $2,274.67	Professional		$178.04	$243.89	$2,274.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $377.04 / $377.04 / $377.04	Professional		$377.04	$377.04	$377.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $377.04 / $377.04 / $377.04	Professional		$377.04	$377.04	$377.04
United Facility/Professional Professional Modifier Low / Median / High Price $147.76 / $204.92 / $334.29	Professional		$147.76	$204.92	$334.29