Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.13 / $138.13 / $138.13	Facility		$138.13	$138.13	$138.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.79 / $138.13 / $229.35	Professional		$93.79	$138.13	$229.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $273.82 / $301.20 / $498.35	Facility		$273.82	$301.20	$498.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.43 / $254.65 / $336.79	Professional		$246.43	$254.65	$336.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $196.98 / $585.97 / $585.97	Facility		$196.98	$585.97	$585.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.51 / $565.65 / $1,143.44	Facility		$194.51	$565.65	$1,143.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.99 / $397.03 / $518.23	Professional		$141.99	$397.03	$518.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.51 / $207.20 / $314.89	Facility		$72.51	$207.20	$314.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $156.79 / $273.82 / $328.58	Professional		$156.79	$273.82	$328.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $125.52 / $273.82 / $1,187.13	Facility		$125.52	$273.82	$1,187.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $169.19 / $298.14	Professional		$113.82	$169.19	$298.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $72.51 / $207.20 / $314.89	Facility		$72.51	$207.20	$314.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $156.79 / $273.82 / $328.58	Professional		$156.79	$273.82	$328.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $273.82 / $421.40 / $673.48	Professional		$273.82	$421.40	$673.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $194.51 / $534.79 / $1,187.13	Facility		$194.51	$534.79	$1,187.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.99 / $194.51 / $1,649.25	Professional		$141.99	$194.51	$1,649.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $273.82 / $273.82 / $273.82	Professional		$273.82	$273.82	$273.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $273.82 / $273.82 / $273.82	Professional		$273.82	$273.82	$273.82
United Facility/Professional Professional Modifier Low / Median / High Price $93.60 / $169.02 / $273.82	Professional		$93.60	$169.02	$273.82