Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.74 / $221.74 / $221.74	Facility		$221.74	$221.74	$221.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.68 / $221.74 / $404.96	Professional		$200.68	$221.74	$404.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $439.56 / $483.52 / $800.00	Facility		$439.56	$483.52	$800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $408.79 / $408.79 / $540.65	Professional		$408.79	$408.79	$540.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $316.20 / $940.66 / $940.66	Facility		$316.20	$940.66	$940.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $305.27 / $909.01 / $1,834.83	Facility		$305.27	$909.01	$1,834.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.85 / $637.03 / $831.90	Professional		$222.85	$637.03	$831.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $123.40 / $332.61 / $505.49	Facility		$123.40	$332.61	$505.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $251.69 / $439.56 / $527.47	Professional		$251.69	$439.56	$527.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $213.62 / $439.56 / $2,036.64	Facility		$213.62	$439.56	$2,036.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.01 / $287.94 / $478.63	Professional		$198.01	$287.94	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $137.09	Professional		$50.00	$70.00	$137.09
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $123.40 / $332.61 / $505.49	Facility		$123.40	$332.61	$505.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $251.69 / $439.56 / $527.47	Professional		$251.69	$439.56	$527.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $439.56 / $676.47 / $1,147.23	Professional		$439.56	$676.47	$1,147.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $305.27 / $858.52 / $2,036.64	Facility		$305.27	$858.52	$2,036.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $222.85 / $305.27 / $2,452.17	Professional		$222.85	$305.27	$2,452.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $439.56 / $439.56 / $439.56	Professional		$439.56	$439.56	$439.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $439.56 / $439.56 / $439.56	Professional		$439.56	$439.56	$439.56
United Facility/Professional Professional Modifier Low / Median / High Price $175.12 / $252.59 / $376.99	Professional		$175.12	$252.59	$376.99