Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.50 / $240.50 / $240.50	Facility		$240.50	$240.50	$240.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.36 / $240.50 / $420.44	Professional		$208.36	$240.50	$420.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $476.75 / $524.42 / $867.69	Facility		$476.75	$524.42	$867.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $443.38 / $443.38 / $586.40	Professional		$443.38	$443.38	$586.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $342.97 / $1,020.25 / $1,020.25	Facility		$342.97	$1,020.25	$1,020.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $280.67 / $985.92 / $1,990.18	Facility		$280.67	$985.92	$1,990.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.89 / $690.94 / $902.30	Professional		$204.89	$690.94	$902.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $130.85 / $360.75 / $548.26	Facility		$130.85	$360.75	$548.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $272.98 / $476.75 / $572.10	Professional		$272.98	$476.75	$572.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $226.50 / $476.75 / $2,155.56	Facility		$226.50	$476.75	$2,155.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $205.40 / $305.31 / $519.12	Professional		$205.40	$305.31	$519.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $158.19	Professional		$50.00	$70.00	$158.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $130.85 / $360.75 / $548.26	Facility		$130.85	$360.75	$548.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $272.98 / $476.75 / $572.10	Professional		$272.98	$476.75	$572.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $476.75 / $733.70 / $1,216.48	Professional		$476.75	$733.70	$1,216.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $280.67 / $931.16 / $2,155.56	Facility		$280.67	$931.16	$2,155.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $204.89 / $280.67 / $2,600.06	Professional		$204.89	$280.67	$2,600.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $476.75 / $476.75 / $476.75	Professional		$476.75	$476.75	$476.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $476.75 / $476.75 / $476.75	Professional		$476.75	$476.75	$476.75
United Facility/Professional Professional Modifier Low / Median / High Price $183.19 / $286.05 / $408.89	Professional		$183.19	$286.05	$408.89