Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.21 / $157.36 / $196.99	Facility		$118.21	$157.36	$196.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.38 / $187.34 / $429.25	Professional		$154.38	$187.34	$429.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $311.94 / $343.13 / $567.73	Facility		$311.94	$343.13	$567.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $280.74 / $290.10 / $383.68	Professional		$280.74	$290.10	$383.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $224.41 / $374.33 / $667.55	Facility		$224.41	$374.33	$667.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $311.94 / $327.54 / $464.00	Professional		$311.94	$327.54	$464.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.92 / $644.48 / $1,301.58	Facility		$194.92	$644.48	$1,301.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.29 / $451.88 / $590.38	Professional		$142.29	$451.88	$590.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $100.47 / $236.04 / $358.73	Facility		$100.47	$236.04	$358.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $178.61 / $311.94 / $374.33	Professional		$178.61	$311.94	$374.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.47 / $311.94 / $1,620.96	Facility		$100.47	$311.94	$1,620.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.30 / $181.56 / $352.17	Professional		$141.30	$181.56	$352.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $204.74	Professional		$50.00	$65.00	$204.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $100.47 / $236.04 / $358.73	Facility		$100.47	$236.04	$358.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $178.61 / $311.94 / $374.33	Professional		$178.61	$311.94	$374.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $311.94 / $467.91 / $933.44	Professional		$311.94	$467.91	$933.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $194.92 / $609.26 / $1,620.96	Facility		$194.92	$609.26	$1,620.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $142.29 / $194.92 / $2,058.80	Professional		$142.29	$194.92	$2,058.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $311.94 / $311.94 / $311.94	Professional		$311.94	$311.94	$311.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $249.08 / $311.94 / $311.94	Professional		$249.08	$311.94	$311.94
United Facility/Professional Professional Modifier Low / Median / High Price $121.85 / $172.77 / $311.94	Professional		$121.85	$172.77	$311.94