Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.93 / $190.93 / $190.93	Facility		$190.93	$190.93	$190.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.93 / $211.49 / $790.00	Professional		$190.93	$211.49	$790.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $378.49 / $416.34 / $688.85	Facility		$378.49	$416.34	$688.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.64 / $352.00 / $465.54	Professional		$340.64	$352.00	$465.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $272.29 / $454.19 / $809.97	Facility		$272.29	$454.19	$809.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $378.49 / $397.41 / $532.77	Professional		$378.49	$397.41	$532.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.27 / $651.20 / $1,580.11	Facility		$211.27	$651.20	$1,580.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.22 / $548.44 / $716.33	Professional		$154.22	$548.44	$716.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $108.90 / $286.39 / $435.26	Facility		$108.90	$286.39	$435.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $216.71 / $369.41 / $454.19	Professional		$216.71	$369.41	$454.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $188.50 / $378.49 / $1,762.49	Facility		$188.50	$378.49	$1,762.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.28 / $198.27 / $412.13	Professional		$165.28	$198.27	$412.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $124.42	Professional		$50.00	$70.00	$124.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $108.90 / $286.39 / $435.26	Facility		$108.90	$286.39	$435.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $216.71 / $369.41 / $454.19	Professional		$216.71	$369.41	$454.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $378.49 / $582.48 / $1,011.73	Professional		$378.49	$582.48	$1,011.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $211.27 / $739.24 / $1,762.49	Facility		$211.27	$739.24	$1,762.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.22 / $211.27 / $1,905.35	Professional		$154.22	$211.27	$1,905.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $378.49 / $378.49 / $378.49	Professional		$378.49	$378.49	$378.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $378.49 / $378.49 / $378.49	Professional		$378.49	$378.49	$378.49
United Facility/Professional Professional Modifier Low / Median / High Price $140.57 / $188.83 / $378.49	Professional		$140.57	$188.83	$378.49