Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.81 / $206.81 / $206.81	Facility		$206.81	$206.81	$206.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.66 / $206.81 / $291.82	Professional		$153.66	$206.81	$291.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $409.96 / $450.96 / $746.13	Facility		$409.96	$450.96	$746.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.96 / $381.26 / $504.25	Professional		$368.96	$381.26	$504.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $294.92 / $877.31 / $877.31	Facility		$294.92	$877.31	$877.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $268.08 / $847.08 / $1,711.67	Facility		$268.08	$847.08	$1,711.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.70 / $593.91 / $775.88	Professional		$195.70	$593.91	$775.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.21 / $310.22 / $471.45	Facility		$104.21	$310.22	$471.45
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $234.73 / $409.96 / $491.95	Professional		$234.73	$409.96	$491.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $180.39 / $409.96 / $1,700.62	Facility		$180.39	$409.96	$1,700.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $159.97 / $204.52 / $446.39	Professional		$159.97	$204.52	$446.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $302.56	Professional		$50.00	$70.00	$302.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $104.21 / $310.22 / $471.45	Facility		$104.21	$310.22	$471.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $234.73 / $409.96 / $491.95	Professional		$234.73	$409.96	$491.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $409.96 / $617.77 / $968.57	Professional		$409.96	$617.77	$968.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $268.08 / $800.70 / $1,700.62	Facility		$268.08	$800.70	$1,700.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $195.70 / $268.08 / $2,451.87	Professional		$195.70	$268.08	$2,451.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $409.96 / $409.96 / $409.96	Professional		$409.96	$409.96	$409.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $409.96 / $409.96 / $409.96	Professional		$409.96	$409.96	$409.96
United Facility/Professional Professional Modifier Low / Median / High Price $146.57 / $204.52 / $409.96	Professional		$146.57	$204.52	$409.96