Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.94 / $159.94 / $159.94	Facility		$159.94	$159.94	$159.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.94 / $162.21 / $308.06	Professional		$159.94	$162.21	$308.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $317.05 / $348.76 / $577.03	Facility		$317.05	$348.76	$577.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $294.86 / $294.86 / $389.97	Professional		$294.86	$294.86	$389.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $228.08 / $678.49 / $678.49	Facility		$228.08	$678.49	$678.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.09 / $655.71 / $1,323.99	Facility		$205.09	$655.71	$1,323.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.72 / $459.38 / $600.04	Professional		$149.72	$459.38	$600.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.11 / $239.91 / $364.61	Facility		$102.11	$239.91	$364.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $181.54 / $317.05 / $422.73	Professional		$181.54	$317.05	$422.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $159.94 / $317.35 / $1,717.61	Facility		$159.94	$317.35	$1,717.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.62 / $184.53 / $357.94	Professional		$143.62	$184.53	$357.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $89.64	Professional		$50.00	$65.00	$89.64
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $102.11 / $239.91 / $364.61	Facility		$102.11	$239.91	$364.61
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $181.54 / $317.05 / $422.73	Professional		$181.54	$317.05	$422.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $317.05 / $487.95 / $949.50	Professional		$317.05	$487.95	$949.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $205.09 / $619.24 / $1,717.61	Facility		$205.09	$619.24	$1,717.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $149.72 / $205.09 / $3,824.46	Professional		$149.72	$205.09	$3,824.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $317.05 / $317.05 / $317.05	Professional		$317.05	$317.05	$317.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $317.05 / $317.05 / $317.05	Professional		$317.05	$317.05	$317.05
United Facility/Professional Professional Modifier Low / Median / High Price $126.31 / $179.87 / $303.16	Professional		$126.31	$179.87	$303.16