Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.43 / $186.43 / $186.43	Facility		$186.43	$186.43	$186.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.50 / $186.43 / $333.31	Professional		$175.50	$186.43	$333.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $369.55 / $406.51 / $672.58	Facility		$369.55	$406.51	$672.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $343.68 / $343.68 / $454.54	Professional		$343.68	$343.68	$454.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $265.86 / $790.84 / $790.84	Facility		$265.86	$790.84	$790.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $230.92 / $763.60 / $1,542.32	Facility		$230.92	$763.60	$1,542.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.57 / $535.30 / $699.40	Professional		$168.57	$535.30	$699.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $119.03 / $279.64 / $424.98	Facility		$119.03	$279.64	$424.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $211.60 / $369.55 / $492.74	Professional		$211.60	$369.55	$492.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $186.43 / $369.55 / $1,940.98	Facility		$186.43	$369.55	$1,940.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.40 / $215.10 / $417.21	Professional		$167.40	$215.10	$417.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $214.82	Professional		$50.00	$70.00	$214.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $119.03 / $279.64 / $424.98	Facility		$119.03	$279.64	$424.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $211.60 / $369.55 / $492.74	Professional		$211.60	$369.55	$492.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $369.55 / $568.72 / $1,106.08	Professional		$369.55	$568.72	$1,106.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $230.92 / $721.78 / $1,940.98	Facility		$230.92	$721.78	$1,940.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $168.57 / $230.92 / $2,973.74	Professional		$168.57	$230.92	$2,973.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $369.55 / $369.55 / $369.55	Professional		$369.55	$369.55	$369.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $369.55 / $369.55 / $369.55	Professional		$369.55	$369.55	$369.55
United Facility/Professional Professional Modifier Low / Median / High Price $147.22 / $198.51 / $345.36	Professional		$147.22	$198.51	$345.36