Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.55 / $175.55 / $175.55	Facility		$175.55	$175.55	$175.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.72 / $175.55 / $291.47	Professional		$108.72	$175.55	$291.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $347.98 / $382.78 / $633.32	Facility		$347.98	$382.78	$633.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $313.18 / $323.62 / $428.01	Professional		$313.18	$323.62	$428.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $250.34 / $744.68 / $744.68	Facility		$250.34	$744.68	$744.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.10 / $719.52 / $1,452.75	Facility		$225.10	$719.52	$1,452.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.32 / $504.38 / $658.59	Professional		$164.32	$504.38	$658.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.06 / $263.33 / $400.18	Facility		$84.06	$263.33	$400.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $199.25 / $312.70 / $417.58	Professional		$199.25	$312.70	$417.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $145.50 / $347.98 / $1,446.87	Facility		$145.50	$347.98	$1,446.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $150.47 / $196.18 / $378.92	Professional		$150.47	$196.18	$378.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $100.86	Professional		$50.00	$65.00	$100.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $84.06 / $263.33 / $400.18	Facility		$84.06	$263.33	$400.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $199.25 / $312.70 / $417.58	Professional		$199.25	$312.70	$417.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $347.98 / $521.97 / $780.88	Professional		$347.98	$521.97	$780.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $225.10 / $679.66 / $1,446.87	Facility		$225.10	$679.66	$1,446.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.32 / $225.10 / $1,670.30	Professional		$164.32	$225.10	$1,670.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $347.98 / $347.98 / $347.98	Professional		$347.98	$347.98	$347.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $347.98 / $347.98 / $347.98	Professional		$347.98	$347.98	$347.98
United Facility/Professional Facility Modifier Low / Median / High Price $0.21 / $195.94 / $196.18	Facility		$0.21	$195.94	$196.18
United Facility/Professional Professional Modifier Low / Median / High Price $115.74 / $186.80 / $347.98	Professional		$115.74	$186.80	$347.98