Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.93 / $151.93 / $151.93	Facility		$151.93	$151.93	$151.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.02 / $151.93 / $271.63	Professional		$143.02	$151.93	$271.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $301.17 / $331.29 / $548.13	Facility		$301.17	$331.29	$548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.05 / $280.08 / $370.43	Professional		$271.05	$280.08	$370.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $216.66 / $644.50 / $644.50	Facility		$216.66	$644.50	$644.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.19 / $622.88 / $1,256.81	Facility		$188.19	$622.88	$1,256.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $436.41 / $569.99	Professional		$137.38	$436.41	$569.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $227.90 / $346.35	Facility		$97.00	$227.90	$346.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $172.44 / $301.17 / $401.56	Professional		$172.44	$301.17	$401.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $151.93 / $301.17 / $1,580.76	Facility		$151.93	$301.17	$1,580.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.43 / $175.29 / $340.02	Professional		$136.43	$175.29	$340.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $201.71	Professional		$50.00	$70.00	$201.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $227.90 / $346.35	Facility		$97.00	$227.90	$346.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $172.44 / $301.17 / $401.56	Professional		$172.44	$301.17	$401.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $301.17 / $463.47 / $901.32	Professional		$301.17	$463.47	$901.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $188.19 / $588.22 / $1,580.76	Facility		$188.19	$588.22	$1,580.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $188.19 / $2,765.07	Professional		$137.38	$188.19	$2,765.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $301.17 / $301.17 / $301.17	Professional		$301.17	$301.17	$301.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $301.17 / $301.17 / $301.17	Professional		$301.17	$301.17	$301.17
United Facility/Professional Professional Modifier Low / Median / High Price $119.99 / $160.34 / $287.98	Professional		$119.99	$160.34	$287.98