Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.29 / $164.29 / $164.29	Facility		$164.29	$164.29	$164.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.68 / $164.29 / $273.77	Professional		$135.68	$164.29	$273.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $325.69 / $358.26 / $592.76	Facility		$325.69	$358.26	$592.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.68 / $302.89 / $400.59	Professional		$281.68	$302.89	$400.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.29 / $696.98 / $696.98	Facility		$234.29	$696.98	$696.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.51 / $673.55 / $1,358.98	Facility		$203.51	$673.55	$1,358.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.56 / $472.03 / $616.38	Professional		$148.56	$472.03	$616.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.90 / $246.44 / $374.54	Facility		$104.90	$246.44	$374.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $186.48 / $325.69 / $434.25	Professional		$186.48	$325.69	$434.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $164.29 / $325.39 / $1,717.84	Facility		$164.29	$325.39	$1,717.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.43 / $217.61 / $367.69	Professional		$151.43	$217.61	$367.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $184.52	Professional		$50.00	$70.00	$184.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $104.90 / $246.44 / $374.54	Facility		$104.90	$246.44	$374.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $186.48 / $325.69 / $434.25	Professional		$186.48	$325.69	$434.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $325.69 / $501.21 / $974.59	Professional		$325.69	$501.21	$974.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $203.51 / $636.10 / $1,717.84	Facility		$203.51	$636.10	$1,717.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $148.56 / $203.51 / $2,162.57	Professional		$148.56	$203.51	$2,162.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.69 / $325.69 / $325.69	Professional		$325.69	$325.69	$325.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.69 / $325.69 / $325.69	Professional		$325.69	$325.69	$325.69
United Facility/Professional Professional Modifier Low / Median / High Price $135.40 / $216.64 / $325.69	Professional		$135.40	$216.64	$325.69