Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.11 / $161.11 / $161.11	Facility		$161.11	$161.11	$161.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.31 / $161.11 / $267.50	Professional		$119.31	$161.11	$267.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $319.37 / $351.31 / $581.25	Facility		$319.37	$351.31	$581.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.30 / $297.01 / $392.82	Professional		$267.30	$297.01	$392.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $229.75 / $683.45 / $683.45	Facility		$229.75	$683.45	$683.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.54 / $660.39 / $1,332.38	Facility		$170.54	$660.39	$1,332.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.49 / $462.66 / $604.42	Professional		$124.49	$462.66	$604.42
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $87.90 / $241.67 / $367.28	Facility		$87.90	$241.67	$367.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $182.86 / $291.55 / $383.24	Professional		$182.86	$291.55	$383.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $152.16 / $319.37 / $1,456.51	Facility		$152.16	$319.37	$1,456.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.99 / $205.11 / $347.75	Professional		$137.99	$205.11	$347.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $215.52	Professional		$50.00	$70.00	$215.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $87.90 / $241.67 / $367.28	Facility		$87.90	$241.67	$367.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $182.86 / $291.55 / $383.24	Professional		$182.86	$291.55	$383.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $319.37 / $491.50 / $817.01	Professional		$319.37	$491.50	$817.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $170.54 / $623.76 / $1,456.51	Facility		$170.54	$623.76	$1,456.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.49 / $170.54 / $1,746.77	Professional		$124.49	$170.54	$1,746.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $319.37 / $319.37 / $319.37	Professional		$319.37	$319.37	$319.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $319.37 / $319.37 / $319.37	Professional		$319.37	$319.37	$319.37
United Facility/Professional Professional Modifier Low / Median / High Price $123.07 / $181.54 / $283.16	Professional		$123.07	$181.54	$283.16