Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.63 / $129.63 / $129.63	Facility		$129.63	$129.63	$129.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.88 / $129.63 / $208.68	Professional		$109.88	$129.63	$208.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $256.98 / $282.68 / $467.70	Facility		$256.98	$282.68	$467.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.28 / $238.99 / $316.08	Professional		$231.28	$238.99	$316.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $184.86 / $549.94 / $549.94	Facility		$184.86	$549.94	$549.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.23 / $530.96 / $1,072.07	Facility		$166.23	$530.96	$1,072.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.35 / $372.19 / $486.36	Professional		$121.35	$372.19	$486.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $194.46 / $295.52	Facility		$74.52	$194.46	$295.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $256.98 / $308.51	Professional		$147.13	$256.98	$308.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.99 / $256.98 / $1,236.41	Facility		$128.99	$256.98	$1,236.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.72 / $134.66 / $288.58	Professional		$106.72	$134.66	$288.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $255.18	Professional		$50.00	$70.00	$255.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $194.46 / $295.52	Facility		$74.52	$194.46	$295.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $256.98 / $308.51	Professional		$147.13	$256.98	$308.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.98 / $395.47 / $692.55	Professional		$256.98	$395.47	$692.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $166.23 / $501.92 / $1,236.41	Facility		$166.23	$501.92	$1,236.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.35 / $166.23 / $2,131.11	Professional		$121.35	$166.23	$2,131.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $256.98 / $256.98 / $256.98	Professional		$256.98	$256.98	$256.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $256.98 / $256.98 / $256.98	Professional		$256.98	$256.98	$256.98
United Facility/Professional Professional Modifier Low / Median / High Price $96.20 / $133.40 / $256.98	Professional		$96.20	$133.40	$256.98