Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.20 / $122.20 / $122.20	Facility		$122.20	$122.20	$122.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.68 / $124.50 / $219.70	Professional		$115.68	$124.50	$219.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $242.23 / $266.45 / $440.86	Facility		$242.23	$266.45	$440.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.79 / $225.27 / $297.94	Professional		$222.79	$225.27	$297.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $174.27 / $518.37 / $518.37	Facility		$174.27	$518.37	$518.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.22 / $535.00 / $1,010.49	Facility		$135.22	$535.00	$1,010.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.22 / $283.68 / $458.44	Professional		$135.22	$283.68	$458.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $69.70 / $183.30 / $278.56	Facility		$69.70	$183.30	$278.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $138.69 / $236.42 / $290.68	Professional		$138.69	$236.42	$290.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.66 / $242.23 / $1,128.10	Facility		$120.66	$242.23	$1,128.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.79 / $126.89 / $263.76	Professional		$105.79	$126.89	$263.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $69.70 / $183.30 / $278.56	Facility		$69.70	$183.30	$278.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $138.69 / $236.42 / $290.68	Professional		$138.69	$236.42	$290.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $242.23 / $372.81 / $647.39	Professional		$242.23	$372.81	$647.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $135.22 / $473.10 / $1,128.10	Facility		$135.22	$473.10	$1,128.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $98.72 / $135.22 / $1,219.95	Professional		$98.72	$135.22	$1,219.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $242.23 / $242.23 / $242.23	Professional		$242.23	$242.23	$242.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $242.23 / $242.23 / $242.23	Professional		$242.23	$242.23	$242.23
United Facility/Professional Professional Modifier Low / Median / High Price $84.54 / $120.85 / $234.53	Professional		$84.54	$120.85	$234.53