Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.25 / $133.25 / $133.25	Facility		$133.25	$133.25	$133.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $133.25 / $221.25	Professional		$101.04	$133.25	$221.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $264.14 / $290.57 / $480.75	Facility		$264.14	$290.57	$480.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.46 / $245.66 / $324.89	Professional		$228.46	$245.66	$324.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.04 / $565.28 / $565.28	Facility		$190.04	$565.28	$565.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.89 / $545.96 / $1,102.85	Facility		$170.89	$545.96	$1,102.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.75 / $382.97 / $499.93	Professional		$124.75	$382.97	$499.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $65.18 / $199.88 / $303.77	Facility		$65.18	$199.88	$303.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $151.26 / $264.14 / $316.98	Professional		$151.26	$264.14	$316.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.83 / $264.14 / $1,122.97	Facility		$112.83	$264.14	$1,122.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.24 / $152.12 / $287.62	Professional		$105.24	$152.12	$287.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $121.26	Professional		$50.00	$70.00	$121.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $65.18 / $199.88 / $303.77	Facility		$65.18	$199.88	$303.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $151.26 / $264.14 / $316.98	Professional		$151.26	$264.14	$316.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $264.14 / $396.23 / $606.23	Professional		$264.14	$396.23	$606.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $170.89 / $515.91 / $1,122.97	Facility		$170.89	$515.91	$1,122.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.75 / $170.89 / $1,327.55	Professional		$124.75	$170.89	$1,327.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $264.14 / $264.14 / $264.14	Professional		$264.14	$264.14	$264.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $264.14 / $264.14 / $264.14	Professional		$264.14	$264.14	$264.14
United Facility/Professional Professional Modifier Low / Median / High Price $87.86 / $151.94 / $264.14	Professional		$87.86	$151.94	$264.14