Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.65 / $180.65 / $180.65	Facility		$180.65	$180.65	$180.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.01 / $180.65 / $302.70	Professional		$150.01	$180.65	$302.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $358.10 / $393.91 / $651.74	Facility		$358.10	$393.91	$651.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $329.36 / $333.03 / $440.46	Professional		$329.36	$333.03	$440.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $257.61 / $766.33 / $766.33	Facility		$257.61	$766.33	$766.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.66 / $790.45 / $1,494.73	Facility		$231.66	$790.45	$1,494.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.11 / $527.21 / $677.74	Professional		$169.11	$527.21	$677.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $103.04 / $270.98 / $411.82	Facility		$103.04	$270.98	$411.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $205.04 / $349.53 / $429.72	Professional		$205.04	$349.53	$429.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $178.36 / $358.10 / $1,667.62	Facility		$178.36	$358.10	$1,667.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $163.52 / $239.27 / $389.93	Professional		$163.52	$239.27	$389.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $91.74	Professional		$50.00	$65.00	$91.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $103.04 / $270.98 / $411.82	Facility		$103.04	$270.98	$411.82
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $205.04 / $349.53 / $429.72	Professional		$205.04	$349.53	$429.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $358.10 / $551.10 / $957.53	Professional		$358.10	$551.10	$957.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $231.66 / $699.42 / $1,667.62	Facility		$231.66	$699.42	$1,667.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.11 / $231.66 / $1,803.01	Professional		$169.11	$231.66	$1,803.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $358.10 / $358.10 / $358.10	Professional		$358.10	$358.10	$358.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $358.10 / $358.10 / $358.10	Professional		$358.10	$358.10	$358.10
United Facility/Professional Professional Modifier Low / Median / High Price $133.01 / $212.81 / $317.50	Professional		$133.01	$212.81	$317.50