Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.48 / $203.48 / $203.48	Facility		$203.48	$203.48	$203.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.66 / $203.48 / $337.86	Professional		$149.66	$203.48	$337.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $403.36 / $443.70 / $734.12	Facility		$403.36	$443.70	$734.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $348.86 / $375.12 / $496.13	Professional		$348.86	$375.12	$496.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $290.18 / $863.19 / $863.19	Facility		$290.18	$863.19	$863.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $271.68 / $833.97 / $1,683.68	Facility		$271.68	$833.97	$1,683.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.33 / $584.53 / $763.40	Professional		$198.33	$584.53	$763.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $108.72 / $305.22 / $463.86	Facility		$108.72	$305.22	$463.86
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $230.95 / $346.59 / $484.03	Professional		$230.95	$346.59	$484.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $188.19 / $403.36 / $1,747.51	Facility		$188.19	$403.36	$1,747.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $178.10 / $253.67 / $439.22	Professional		$178.10	$253.67	$439.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $227.80	Professional		$50.00	$70.00	$227.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $108.72 / $305.22 / $463.86	Facility		$108.72	$305.22	$463.86
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $230.95 / $346.59 / $484.03	Professional		$230.95	$346.59	$484.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $403.36 / $620.77 / $1,010.73	Professional		$403.36	$620.77	$1,010.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $271.68 / $787.82 / $1,747.51	Facility		$271.68	$787.82	$1,747.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $198.33 / $271.68 / $1,856.00	Professional		$198.33	$271.68	$1,856.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $403.36 / $403.36 / $403.36	Professional		$403.36	$403.36	$403.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $403.36 / $403.36 / $403.36	Professional		$403.36	$403.36	$403.36
United Facility/Professional Professional Modifier Low / Median / High Price $152.19 / $242.02 / $345.95	Professional		$152.19	$242.02	$345.95