Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.80 / $172.27 / $187.66	Facility		$149.80	$172.27	$187.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.80 / $159.34 / $266.70	Professional		$141.80	$159.34	$266.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $296.95 / $326.66 / $540.47	Facility		$296.95	$326.66	$540.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.26 / $276.17 / $365.26	Professional		$267.26	$276.17	$365.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $213.63 / $635.49 / $635.49	Facility		$213.63	$635.49	$635.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.58 / $655.22 / $1,240.01	Facility		$176.58	$655.22	$1,240.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.58 / $347.69 / $562.03	Professional		$176.58	$347.69	$562.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.45 / $223.20 / $341.50	Facility		$85.45	$223.20	$341.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $170.03 / $289.86 / $356.35	Professional		$170.03	$289.86	$356.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $296.95 / $1,382.94	Facility		$147.91	$296.95	$1,382.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.68 / $155.56 / $323.35	Professional		$129.68	$155.56	$323.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.68 / $55.00 / $85.00	Professional		$29.68	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $85.45 / $224.70 / $341.50	Facility		$85.45	$224.70	$341.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $170.03 / $289.86 / $356.35	Professional		$170.03	$289.86	$356.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $296.95 / $457.02 / $793.93	Professional		$296.95	$457.02	$793.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $176.58 / $580.00 / $1,382.94	Facility		$176.58	$580.00	$1,382.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.90 / $176.58 / $1,495.20	Professional		$128.90	$176.58	$1,495.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $296.95 / $296.95 / $296.95	Professional		$296.95	$296.95	$296.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $237.12 / $296.95 / $296.95	Professional		$237.12	$296.95	$296.95
United Facility/Professional Professional Modifier Low / Median / High Price $103.64 / $148.15 / $282.99	Professional		$103.64	$148.15	$282.99