Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.49 / $208.93 / $350.09	Professional		$173.49	$208.93	$350.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $414.17 / $455.59 / $753.79	Facility		$414.17	$455.59	$753.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.92 / $385.18 / $509.42	Professional		$380.92	$385.18	$509.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $297.95 / $886.32 / $886.32	Facility		$297.95	$886.32	$886.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $267.94 / $914.65 / $1,728.46	Facility		$267.94	$914.65	$1,728.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.60 / $609.60 / $783.84	Professional		$195.60	$609.60	$783.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $119.17 / $313.39 / $476.30	Facility		$119.17	$313.39	$476.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $237.15 / $404.30 / $497.00	Professional		$237.15	$404.30	$497.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $206.30 / $414.17 / $1,928.91	Facility		$206.30	$414.17	$1,928.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $189.13 / $276.75 / $450.98	Professional		$189.13	$276.75	$450.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $119.17 / $313.39 / $476.30	Facility		$119.17	$313.39	$476.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $237.15 / $404.30 / $497.00	Professional		$237.15	$404.30	$497.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $414.17 / $637.38 / $1,108.08	Professional		$414.17	$637.38	$1,108.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $267.94 / $808.92 / $1,928.91	Facility		$267.94	$808.92	$1,928.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $195.60 / $267.94 / $2,085.52	Professional		$195.60	$267.94	$2,085.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $414.17 / $414.17 / $414.17	Professional		$414.17	$414.17	$414.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $414.17 / $414.17 / $414.17	Professional		$414.17	$414.17	$414.17
United Facility/Professional Professional Modifier Low / Median / High Price $153.84 / $248.50 / $414.17	Professional		$153.84	$248.50	$414.17