Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.25 / $143.25 / $143.25	Facility		$143.25	$143.25	$143.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.93 / $143.25 / $246.76	Professional		$129.93	$143.25	$246.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $283.97 / $312.37 / $516.83	Facility		$283.97	$312.37	$516.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.08 / $264.08 / $349.28	Professional		$264.08	$264.08	$349.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $204.28 / $607.70 / $607.70	Facility		$204.28	$607.70	$607.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.96 / $587.25 / $1,185.43	Facility		$170.96	$587.25	$1,185.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.80 / $472.93 / $537.42	Professional		$124.80	$472.93	$537.42
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $88.12 / $214.88 / $326.57	Facility		$88.12	$214.88	$326.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $162.58 / $283.97 / $364.80	Professional		$162.58	$283.97	$364.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $143.25 / $283.97 / $1,435.50	Facility		$143.25	$283.97	$1,435.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.20 / $159.24 / $320.58	Professional		$126.20	$159.24	$320.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $133.91	Professional		$50.00	$70.00	$133.91
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $88.12 / $214.88 / $326.57	Facility		$88.12	$214.88	$326.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $162.58 / $283.97 / $364.80	Professional		$162.58	$283.97	$364.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $283.97 / $437.01 / $819.02	Professional		$283.97	$437.01	$819.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $170.96 / $554.62 / $1,435.50	Facility		$170.96	$554.62	$1,435.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.80 / $170.96 / $2,366.10	Professional		$124.80	$170.96	$2,366.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $283.97 / $283.97 / $283.97	Professional		$283.97	$283.97	$283.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $226.73 / $283.97 / $283.97	Professional		$226.73	$283.97	$283.97
United Facility/Professional Professional Modifier Low / Median / High Price $106.88 / $141.66 / $271.52	Professional		$106.88	$141.66	$271.52