Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.64 / $189.64 / $189.64	Facility		$189.64	$189.64	$189.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.91 / $189.64 / $314.87	Professional		$145.91	$189.64	$314.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $375.92 / $413.51 / $684.17	Facility		$375.92	$413.51	$684.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.32 / $349.61 / $462.38	Professional		$338.32	$349.61	$462.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $270.44 / $804.47 / $804.47	Facility		$270.44	$804.47	$804.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.19 / $777.66 / $1,568.91	Facility		$243.19	$777.66	$1,568.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.53 / $544.69 / $711.46	Professional		$177.53	$544.69	$711.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $112.81 / $284.45 / $432.31	Facility		$112.81	$284.45	$432.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $215.26 / $375.92 / $467.02	Professional		$215.26	$375.92	$467.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $189.64 / $375.92 / $1,857.26	Facility		$189.64	$375.92	$1,857.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.79 / $251.20 / $424.44	Professional		$174.79	$251.20	$424.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $252.14	Professional		$50.00	$70.00	$252.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $112.81 / $290.14 / $432.31	Facility		$112.81	$290.14	$432.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $215.26 / $375.92 / $467.02	Professional		$215.26	$375.92	$467.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $375.92 / $578.53 / $1,048.86	Professional		$375.92	$578.53	$1,048.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $243.19 / $734.22 / $1,857.26	Facility		$243.19	$734.22	$1,857.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.53 / $243.19 / $2,627.87	Professional		$177.53	$243.19	$2,627.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $375.92 / $375.92 / $375.92	Professional		$375.92	$375.92	$375.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $375.92 / $375.92 / $375.92	Professional		$375.92	$375.92	$375.92
United Facility/Professional Professional Modifier Low / Median / High Price $145.62 / $232.99 / $375.92	Professional		$145.62	$232.99	$375.92