Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.75 / $125.75 / $125.75	Facility		$125.75	$125.75	$125.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.07 / $125.75 / $208.79	Professional		$88.07	$125.75	$208.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $249.27 / $274.20 / $453.67	Facility		$249.27	$274.20	$453.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.82 / $231.82 / $306.60	Professional		$231.82	$231.82	$306.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $179.33 / $533.44 / $533.44	Facility		$179.33	$533.44	$533.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.47 / $515.00 / $1,039.88	Facility		$166.47	$515.00	$1,039.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.52 / $361.41 / $471.76	Professional		$121.52	$361.41	$471.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $68.09 / $188.63 / $286.66	Facility		$68.09	$188.63	$286.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $142.74 / $249.27 / $299.12	Professional		$142.74	$249.27	$299.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.86 / $249.27 / $1,123.06	Facility		$117.86	$249.27	$1,123.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.29 / $158.87 / $271.43	Professional		$112.29	$158.87	$271.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $152.90	Professional		$50.00	$70.00	$152.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $68.09 / $188.63 / $286.66	Facility		$68.09	$188.63	$286.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $142.74 / $249.27 / $299.12	Professional		$142.74	$249.27	$299.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $249.27 / $383.63 / $632.33	Professional		$249.27	$383.63	$632.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $166.47 / $486.86 / $1,123.06	Facility		$166.47	$486.86	$1,123.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.52 / $166.47 / $1,352.98	Professional		$121.52	$166.47	$1,352.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $249.27 / $249.27 / $249.27	Professional		$249.27	$249.27	$249.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $249.27 / $249.27 / $249.27	Professional		$249.27	$249.27	$249.27
United Facility/Professional Professional Modifier Low / Median / High Price $95.32 / $158.71 / $213.79	Professional		$95.32	$158.71	$213.79