Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.45 / $203.45 / $203.45	Facility		$203.45	$203.45	$203.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.61 / $224.00 / $452.02	Professional		$199.61	$224.00	$452.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $403.29 / $443.62 / $733.99	Facility		$403.29	$443.62	$733.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.96 / $375.06 / $496.04	Professional		$362.96	$375.06	$496.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $290.13 / $863.04 / $863.04	Facility		$290.13	$863.04	$863.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $260.88 / $833.97 / $1,683.68	Facility		$260.88	$833.97	$1,683.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.44 / $584.53 / $763.26	Professional		$190.44	$584.53	$763.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $129.88 / $305.18 / $463.78	Facility		$129.88	$305.18	$463.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $230.91 / $403.29 / $523.47	Professional		$230.91	$403.29	$523.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $203.45 / $400.23 / $2,277.66	Facility		$203.45	$400.23	$2,277.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.51 / $269.47 / $455.30	Professional		$187.51	$269.47	$455.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $235.27	Professional		$50.00	$70.00	$235.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $129.88 / $305.18 / $463.78	Facility		$129.88	$305.18	$463.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $230.91 / $403.29 / $523.47	Professional		$230.91	$403.29	$523.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $403.29 / $620.65 / $1,207.45	Professional		$403.29	$620.65	$1,207.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $260.88 / $787.68 / $2,277.66	Facility		$260.88	$787.68	$2,277.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.44 / $260.88 / $2,677.85	Professional		$190.44	$260.88	$2,677.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $403.29 / $403.29 / $403.29	Professional		$403.29	$403.29	$403.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $322.01 / $403.29 / $403.29	Professional		$322.01	$403.29	$403.29
United Facility/Professional Professional Modifier Low / Median / High Price $160.66 / $266.25 / $357.57	Professional		$160.66	$266.25	$357.57