Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.00 / $214.00 / $214.00	Facility		$214.00	$214.00	$214.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.85 / $214.00 / $499.00	Professional		$161.85	$214.00	$499.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $424.21 / $466.63 / $772.06	Facility		$424.21	$466.63	$772.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.78 / $394.52 / $521.77	Professional		$381.78	$394.52	$521.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $305.17 / $907.81 / $907.81	Facility		$305.17	$907.81	$907.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.50 / $877.11 / $1,770.45	Facility		$229.50	$877.11	$1,770.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.54 / $614.53 / $802.85	Professional		$167.54	$614.53	$802.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.77 / $318.86 / $487.84	Facility		$109.77	$318.86	$487.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $242.89 / $424.21 / $509.05	Professional		$242.89	$424.21	$509.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $190.01 / $424.21 / $1,920.53	Facility		$190.01	$424.21	$1,920.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $211.63 / $461.91	Professional		$169.00	$211.63	$461.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $200.35	Professional		$50.00	$70.00	$200.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $109.77 / $321.00 / $487.84	Facility		$109.77	$321.00	$487.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $242.89 / $424.21 / $509.05	Professional		$242.89	$424.21	$509.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $424.21 / $636.32 / $1,019.76	Professional		$424.21	$636.32	$1,019.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $229.50 / $828.54 / $1,920.53	Facility		$229.50	$828.54	$1,920.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $167.54 / $229.50 / $2,381.81	Professional		$167.54	$229.50	$2,381.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $424.21 / $424.21 / $424.21	Professional		$424.21	$424.21	$424.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $338.72 / $424.21 / $424.21	Professional		$338.72	$424.21	$424.21
United Facility/Professional Professional Modifier Low / Median / High Price $141.69 / $211.63 / $425.07	Professional		$141.69	$211.63	$425.07