Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.00 / $176.00 / $176.00	Facility		$176.00	$176.00	$176.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.27 / $176.00 / $292.23	Professional		$125.27	$176.00	$292.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $348.89 / $383.78 / $634.98	Facility		$348.89	$383.78	$634.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $324.47 / $324.47 / $429.13	Professional		$324.47	$324.47	$429.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $250.99 / $746.62 / $746.62	Facility		$250.99	$746.62	$746.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.68 / $721.39 / $1,456.95	Facility		$225.68	$721.39	$1,456.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.75 / $505.78 / $660.30	Professional		$164.75	$505.78	$660.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $96.85 / $264.00 / $401.22	Facility		$96.85	$264.00	$401.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $199.76 / $309.88 / $418.67	Professional		$199.76	$309.88	$418.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $167.66 / $348.89 / $1,614.69	Facility		$167.66	$348.89	$1,614.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $152.04 / $225.98 / $379.90	Professional		$152.04	$225.98	$379.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $189.62	Professional		$50.00	$70.00	$189.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $96.85 / $264.00 / $401.22	Facility		$96.85	$264.00	$401.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $199.76 / $309.88 / $418.67	Professional		$199.76	$309.88	$418.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $348.89 / $536.94 / $900.32	Professional		$348.89	$536.94	$900.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $225.68 / $681.42 / $1,614.69	Facility		$225.68	$681.42	$1,614.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.75 / $225.68 / $1,996.78	Professional		$164.75	$225.68	$1,996.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $348.89 / $348.89 / $348.89	Professional		$348.89	$348.89	$348.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $348.89 / $348.89 / $348.89	Professional		$348.89	$348.89	$348.89
United Facility/Professional Professional Modifier Low / Median / High Price $125.02 / $209.33 / $299.23	Professional		$125.02	$209.33	$299.23