Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.77 / $145.77 / $145.77	Facility		$145.77	$145.77	$145.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.70 / $145.77 / $238.73	Professional		$125.70	$145.77	$238.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.95 / $317.85 / $525.89	Facility		$288.95	$317.85	$525.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $268.72 / $268.72 / $355.40	Professional		$268.72	$268.72	$355.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $207.87 / $618.35 / $618.35	Facility		$207.87	$618.35	$618.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.40 / $597.55 / $1,206.42	Facility		$165.40	$597.55	$1,206.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.74 / $418.59 / $546.86	Professional		$120.74	$418.59	$546.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.25 / $218.66 / $332.29	Facility		$85.25	$218.66	$332.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $165.46 / $288.95 / $352.93	Professional		$165.46	$288.95	$352.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $145.77 / $288.95 / $1,428.20	Facility		$145.77	$288.95	$1,428.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.10 / $154.06 / $326.24	Professional		$122.10	$154.06	$326.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $158.19	Professional		$50.00	$70.00	$158.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $85.25 / $218.66 / $332.29	Facility		$85.25	$218.66	$332.29
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $165.46 / $288.95 / $352.93	Professional		$165.46	$288.95	$352.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $288.95 / $444.70 / $791.92	Professional		$288.95	$444.70	$791.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $165.40 / $564.36 / $1,428.20	Facility		$165.40	$564.36	$1,428.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.74 / $165.40 / $2,217.51	Professional		$120.74	$165.40	$2,217.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $288.95 / $288.95 / $288.95	Professional		$288.95	$288.95	$288.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $288.95 / $288.95 / $288.95	Professional		$288.95	$288.95	$288.95
United Facility/Professional Professional Modifier Low / Median / High Price $110.05 / $154.06 / $288.95	Professional		$110.05	$154.06	$288.95