Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.97 / $163.97 / $163.97	Facility		$163.97	$163.97	$163.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.61 / $163.97 / $272.25	Professional		$122.61	$163.97	$272.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $325.04 / $357.54 / $591.57	Facility		$325.04	$357.54	$591.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.12 / $302.29 / $399.79	Professional		$281.12	$302.29	$399.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $233.84 / $695.59 / $695.59	Facility		$233.84	$695.59	$695.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.52 / $671.67 / $1,356.18	Facility		$166.52	$671.67	$1,356.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.56 / $471.09 / $615.16	Professional		$121.56	$471.09	$615.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.83 / $245.96 / $373.80	Facility		$85.83	$245.96	$373.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $186.10 / $283.64 / $390.05	Professional		$186.10	$283.64	$390.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $148.58 / $325.04 / $1,389.02	Facility		$148.58	$325.04	$1,389.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $146.41 / $200.28 / $353.93	Professional		$146.41	$200.28	$353.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $179.85	Professional		$50.00	$70.00	$179.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $85.83 / $245.96 / $373.80	Facility		$85.83	$245.96	$373.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $186.10 / $283.64 / $390.05	Professional		$186.10	$283.64	$390.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $325.04 / $500.24 / $797.94	Professional		$325.04	$500.24	$797.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $166.52 / $634.84 / $1,389.02	Facility		$166.52	$634.84	$1,389.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.56 / $166.52 / $1,758.88	Professional		$121.56	$166.52	$1,758.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.04 / $325.04 / $325.04	Professional		$325.04	$325.04	$325.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.04 / $325.04 / $325.04	Professional		$325.04	$325.04	$325.04
United Facility/Professional Professional Modifier Low / Median / High Price $110.80 / $193.06 / $288.19	Professional		$110.80	$193.06	$288.19