Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $184.29 / $184.29 / $184.29	Facility		$184.29	$184.29	$184.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.72 / $184.29 / $334.41	Professional		$165.72	$184.29	$334.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $365.32 / $401.85 / $664.88	Facility		$365.32	$401.85	$664.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $328.78 / $339.75 / $449.34	Professional		$328.78	$339.75	$449.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $262.81 / $781.78 / $781.78	Facility		$262.81	$781.78	$781.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.28 / $755.15 / $1,525.52	Facility		$228.28	$755.15	$1,525.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.64 / $529.22 / $691.40	Professional		$166.64	$529.22	$691.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $117.66 / $276.44 / $420.12	Facility		$117.66	$276.44	$420.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $209.18 / $365.32 / $438.38	Professional		$209.18	$365.32	$438.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $184.29 / $365.32 / $1,903.31	Facility		$184.29	$365.32	$1,903.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.86 / $244.10 / $412.44	Professional		$169.86	$244.10	$412.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $246.54	Professional		$50.00	$70.00	$246.54
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $117.66 / $279.32 / $420.12	Facility		$117.66	$279.32	$420.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $209.18 / $365.32 / $438.38	Professional		$209.18	$365.32	$438.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $365.32 / $562.24 / $1,094.03	Professional		$365.32	$562.24	$1,094.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $228.28 / $713.52 / $1,903.31	Facility		$228.28	$713.52	$1,903.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $166.64 / $228.28 / $2,245.58	Professional		$166.64	$228.28	$2,245.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $365.32 / $365.32 / $365.32	Professional		$365.32	$365.32	$365.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $365.32 / $365.32 / $365.32	Professional		$365.32	$365.32	$365.32
United Facility/Professional Professional Modifier Low / Median / High Price $145.54 / $219.19 / $365.32	Professional		$145.54	$219.19	$365.32