Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.09 / $214.09 / $214.09	Facility		$214.09	$214.09	$214.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.22 / $214.09 / $355.47	Professional		$173.22	$214.09	$355.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $424.39 / $466.83 / $772.39	Facility		$424.39	$466.83	$772.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $367.05 / $394.68 / $521.99	Professional		$367.05	$394.68	$521.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $305.30 / $908.19 / $908.19	Facility		$305.30	$908.19	$908.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $274.52 / $877.11 / $1,771.85	Facility		$274.52	$877.11	$1,771.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.41 / $615.00 / $803.19	Professional		$200.41	$615.00	$803.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $133.44 / $321.14 / $488.05	Facility		$133.44	$321.14	$488.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $242.99 / $424.39 / $551.34	Professional		$242.99	$424.39	$551.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $214.09 / $424.39 / $2,227.59	Facility		$214.09	$424.39	$2,227.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $197.32 / $283.56 / $479.12	Professional		$197.32	$283.56	$479.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $119.02	Professional		$50.00	$70.00	$119.02
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $133.44 / $327.56 / $488.05	Facility		$133.44	$327.56	$488.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $242.99 / $424.39 / $551.34	Professional		$242.99	$424.39	$551.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $424.39 / $653.12 / $1,240.57	Professional		$424.39	$653.12	$1,240.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $274.52 / $828.88 / $2,227.59	Facility		$274.52	$828.88	$2,227.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $200.41 / $274.52 / $2,646.43	Professional		$200.41	$274.52	$2,646.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $424.39 / $424.39 / $424.39	Professional		$424.39	$424.39	$424.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $335.31 / $424.39 / $424.39	Professional		$335.31	$424.39	$424.39
United Facility/Professional Professional Modifier Low / Median / High Price $169.07 / $273.14 / $376.27	Professional		$169.07	$273.14	$376.27