Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.99 / $173.99 / $173.99	Facility		$173.99	$173.99	$173.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.76 / $173.99 / $288.89	Professional		$107.76	$173.99	$288.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $344.90 / $379.39 / $627.72	Facility		$344.90	$379.39	$627.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.41 / $320.76 / $424.22	Professional		$310.41	$320.76	$424.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $248.13 / $738.09 / $738.09	Facility		$248.13	$738.09	$738.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.63 / $712.95 / $1,440.15	Facility		$161.63	$712.95	$1,440.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.99 / $499.69 / $652.76	Professional		$117.99	$499.69	$652.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $83.31 / $260.99 / $396.64	Facility		$83.31	$260.99	$396.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $197.48 / $258.68 / $413.88	Professional		$197.48	$258.68	$413.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.22 / $344.90 / $1,316.67	Facility		$144.22	$344.90	$1,316.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.41 / $194.44 / $375.55	Professional		$137.41	$194.44	$375.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.23 / $58.40 / $85.00	Professional		$43.23	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $83.31 / $260.99 / $396.64	Facility		$83.31	$260.99	$396.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $197.48 / $258.68 / $413.88	Professional		$197.48	$258.68	$413.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $344.90 / $517.35 / $773.85	Professional		$344.90	$517.35	$773.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $161.63 / $673.64 / $1,316.67	Facility		$161.63	$673.64	$1,316.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.99 / $161.63 / $1,707.26	Professional		$117.99	$161.63	$1,707.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $344.90 / $344.90 / $344.90	Professional		$344.90	$344.90	$344.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $344.90 / $344.90 / $344.90	Professional		$344.90	$344.90	$344.90
United Facility/Professional Facility Modifier Low / Median / High Price $0.21 / $194.20 / $194.44	Facility		$0.21	$194.20	$194.44
United Facility/Professional Professional Modifier Low / Median / High Price $114.71 / $194.20 / $305.79	Professional		$114.71	$194.20	$305.79