Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.66 / $225.66 / $225.66	Facility		$225.66	$225.66	$225.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.34 / $225.66 / $378.03	Professional		$187.34	$225.66	$378.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $447.32 / $492.05 / $814.12	Facility		$447.32	$492.05	$814.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $402.58 / $416.01 / $550.20	Professional		$402.58	$416.01	$550.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $321.80 / $957.26 / $957.26	Facility		$321.80	$957.26	$957.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $318.35 / $987.80 / $1,867.02	Facility		$318.35	$987.80	$1,867.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.40 / $658.65 / $846.60	Professional		$232.40	$658.65	$846.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $338.49 / $514.41	Facility		$128.69	$338.49	$514.41
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $256.12 / $436.60 / $536.78	Professional		$256.12	$436.60	$536.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $222.78 / $447.32 / $2,083.02	Facility		$222.78	$447.32	$2,083.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $204.26 / $298.88 / $487.08	Professional		$204.26	$298.88	$487.08
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 $128.69 / $338.49 / $514.41	Facility		$128.69	$338.49	$514.41
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $256.12 / $436.60 / $536.78	Professional		$256.12	$436.60	$536.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $447.32 / $688.41 / $1,196.41	Professional		$447.32	$688.41	$1,196.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $318.35 / $873.68 / $2,083.02	Facility		$318.35	$873.68	$2,083.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $232.40 / $318.35 / $2,252.01	Professional		$232.40	$318.35	$2,252.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $447.32 / $447.32 / $447.32	Professional		$447.32	$447.32	$447.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $447.32 / $447.32 / $447.32	Professional		$447.32	$447.32	$447.32
United Facility/Professional Professional Modifier Low / Median / High Price $166.13 / $265.81 / $447.32	Professional		$166.13	$265.81	$447.32