Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.77 / $238.77 / $238.77	Facility		$238.77	$238.77	$238.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.82 / $238.77 / $396.44	Professional		$165.82	$238.77	$396.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $473.30 / $520.63 / $861.41	Facility		$473.30	$520.63	$861.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $409.35 / $440.17 / $582.15	Professional		$409.35	$440.17	$582.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $340.49 / $1,012.86 / $1,012.86	Facility		$340.49	$1,012.86	$1,012.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $306.16 / $978.41 / $1,976.18	Facility		$306.16	$978.41	$1,976.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.50 / $685.78 / $895.76	Professional		$223.50	$685.78	$895.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $128.19 / $358.16 / $544.29	Facility		$128.19	$358.16	$544.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $270.99 / $473.30 / $567.96	Professional		$270.99	$473.30	$567.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $221.92 / $473.30 / $2,089.06	Facility		$221.92	$473.30	$2,089.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $212.27 / $299.14 / $515.37	Professional		$212.27	$299.14	$515.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $268.62	Professional		$50.00	$70.00	$268.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $128.19 / $358.16 / $544.29	Facility		$128.19	$358.16	$544.29
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $270.99 / $473.30 / $567.96	Professional		$270.99	$473.30	$567.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $473.30 / $728.41 / $1,191.39	Professional		$473.30	$728.41	$1,191.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $306.16 / $924.42 / $2,089.06	Facility		$306.16	$924.42	$2,089.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $223.50 / $306.16 / $2,347.44	Professional		$223.50	$306.16	$2,347.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $473.30 / $473.30 / $473.30	Professional		$473.30	$473.30	$473.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $473.30 / $473.30 / $473.30	Professional		$473.30	$473.30	$473.30
United Facility/Professional Professional Modifier Low / Median / High Price $157.41 / $264.77 / $458.20	Professional		$157.41	$264.77	$458.20