Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.41 / $134.41 / $134.41	Facility		$134.41	$134.41	$134.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $134.41 / $223.17	Professional		$88.93	$134.41	$223.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $266.44 / $293.08 / $484.92	Facility		$266.44	$293.08	$484.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.79 / $247.79 / $327.72	Professional		$247.79	$247.79	$327.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $191.67 / $570.17 / $570.17	Facility		$191.67	$570.17	$570.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.35 / $550.66 / $1,112.65	Facility		$172.35	$550.66	$1,112.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $386.25 / $504.25	Professional		$125.82	$386.25	$504.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.36 / $201.62 / $306.41	Facility		$64.36	$201.62	$306.41
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $152.55 / $266.44 / $319.73	Professional		$152.55	$266.44	$319.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $111.41 / $265.44 / $1,046.34	Facility		$111.41	$265.44	$1,046.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.78 / $150.19 / $290.12	Professional		$110.78	$150.19	$290.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $126.53	Professional		$50.00	$70.00	$126.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.36 / $201.62 / $306.41	Facility		$64.36	$201.62	$306.41
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $152.55 / $266.44 / $319.73	Professional		$152.55	$266.44	$319.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $266.44 / $399.66 / $598.21	Professional		$266.44	$399.66	$598.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $172.35 / $520.38 / $1,046.34	Facility		$172.35	$520.38	$1,046.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $172.35 / $1,431.09	Professional		$125.82	$172.35	$1,431.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $266.44 / $266.44 / $266.44	Professional		$266.44	$266.44	$266.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $266.44 / $266.44 / $266.44	Professional		$266.44	$266.44	$266.44
United Facility/Professional Facility Modifier Low / Median / High Price $0.16 / $150.02 / $153.62	Facility		$0.16	$150.02	$153.62
United Facility/Professional Professional Modifier Low / Median / High Price $90.10 / $132.91 / $236.23	Professional		$90.10	$132.91	$236.23