Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.42 / $192.42 / $192.42	Facility		$192.42	$192.42	$192.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.90 / $192.42 / $320.63	Professional		$158.90	$192.42	$320.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $381.43 / $419.57 / $694.20	Facility		$381.43	$419.57	$694.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $343.28 / $354.73 / $469.15	Professional		$343.28	$354.73	$469.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $274.39 / $816.26 / $816.26	Facility		$274.39	$816.26	$816.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $248.05 / $788.93 / $1,592.70	Facility		$248.05	$788.93	$1,592.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.08 / $552.66 / $721.89	Professional		$181.08	$552.66	$721.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $122.85 / $288.63 / $438.64	Facility		$122.85	$288.63	$438.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $218.40 / $381.43 / $457.72	Professional		$218.40	$381.43	$457.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $192.42 / $381.43 / $2,003.74	Facility		$192.42	$381.43	$2,003.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $177.35 / $254.87 / $415.33	Professional		$177.35	$254.87	$415.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $254.17	Professional		$50.00	$70.00	$254.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $122.85 / $294.39 / $438.64	Facility		$122.85	$294.39	$438.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $218.40 / $381.43 / $457.72	Professional		$218.40	$381.43	$457.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $381.43 / $587.03 / $1,142.21	Professional		$381.43	$587.03	$1,142.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $248.05 / $744.98 / $2,003.74	Facility		$248.05	$744.98	$2,003.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.08 / $248.05 / $2,517.42	Professional		$181.08	$248.05	$2,517.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $381.43 / $381.43 / $381.43	Professional		$381.43	$381.43	$381.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $381.43 / $381.43 / $381.43	Professional		$381.43	$381.43	$381.43
United Facility/Professional Professional Modifier Low / Median / High Price $151.96 / $253.73 / $327.14	Professional		$151.96	$253.73	$327.14