Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $250.73 / $250.73 / $250.73	Facility		$250.73	$250.73	$250.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.17 / $250.73 / $420.06	Professional		$208.17	$250.73	$420.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $497.03 / $546.73 / $904.59	Facility		$497.03	$546.73	$904.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $447.32 / $462.24 / $611.34	Professional		$447.32	$462.24	$611.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $357.56 / $1,063.64 / $1,063.64	Facility		$357.56	$1,063.64	$1,063.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $321.50 / $1,097.02 / $2,074.15	Facility		$321.50	$1,097.02	$2,074.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.70 / $827.78 / $940.66	Professional		$234.70	$827.78	$940.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $143.01 / $397.62 / $571.58	Facility		$143.01	$397.62	$571.58
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $284.57 / $485.15 / $596.44	Professional		$284.57	$485.15	$596.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $250.73 / $497.03 / $2,314.59	Facility		$250.73	$497.03	$2,314.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $228.14 / $333.35 / $541.20	Professional		$228.14	$333.35	$541.20
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 $143.01 / $397.62 / $571.58	Facility		$143.01	$397.62	$571.58
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $284.57 / $485.15 / $596.44	Professional		$284.57	$485.15	$596.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $764.90 / $1,328.90	Professional		$497.03	$764.90	$1,328.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $321.50 / $970.76 / $2,314.59	Facility		$321.50	$970.76	$2,314.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $234.70 / $321.50 / $2,502.40	Professional		$234.70	$321.50	$2,502.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $497.03 / $497.03	Professional		$497.03	$497.03	$497.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $497.03 / $497.03	Professional		$497.03	$497.03	$497.03
United Facility/Professional Professional Modifier Low / Median / High Price $198.01 / $295.36 / $426.27	Professional		$198.01	$295.36	$426.27