Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.96 / $151.96 / $151.96	Facility		$151.96	$151.96	$151.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.05 / $151.96 / $271.67	Professional		$143.05	$151.96	$271.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $301.22 / $331.34 / $548.22	Facility		$301.22	$331.34	$548.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.08 / $280.13 / $370.50	Professional		$271.08	$280.13	$370.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $216.70 / $644.61 / $644.61	Facility		$216.70	$644.61	$644.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.22 / $622.88 / $1,256.81	Facility		$188.22	$622.88	$1,256.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.40 / $436.41 / $570.09	Professional		$137.40	$436.41	$570.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $97.02 / $227.94 / $346.40	Facility		$97.02	$227.94	$346.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $172.47 / $301.22 / $401.63	Professional		$172.47	$301.22	$401.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $151.96 / $316.27 / $1,633.27	Facility		$151.96	$316.27	$1,633.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.44 / $178.76 / $340.07	Professional		$136.44	$178.76	$340.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $257.19	Professional		$50.00	$70.00	$257.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $97.02 / $227.94 / $346.40	Facility		$97.02	$227.94	$346.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $172.47 / $301.22 / $401.63	Professional		$172.47	$301.22	$401.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $301.22 / $463.59 / $901.32	Professional		$301.22	$463.59	$901.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $188.22 / $588.32 / $1,633.27	Facility		$188.22	$588.32	$1,633.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $137.40 / $188.22 / $2,249.42	Professional		$137.40	$188.22	$2,249.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $301.22 / $301.22 / $301.22	Professional		$301.22	$301.22	$301.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $240.52 / $301.22 / $301.22	Professional		$240.52	$301.22	$301.22
United Facility/Professional Facility Modifier Low / Median / High Price $204.62 / $204.62 / $204.62	Facility		$204.62	$204.62	$204.62
United Facility/Professional Professional Modifier Low / Median / High Price $120.01 / $166.84 / $288.02	Professional		$120.01	$166.84	$288.02