Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.69 / $137.69 / $137.69	Facility		$137.69	$137.69	$137.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.99 / $137.69 / $230.03	Professional		$113.99	$137.69	$230.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $272.94 / $300.23 / $496.75	Facility		$272.94	$300.23	$496.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.83 / $253.83 / $335.71	Professional		$253.83	$253.83	$335.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $196.36 / $584.09 / $584.09	Facility		$196.36	$584.09	$584.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.64 / $564.73 / $1,139.25	Facility		$170.64	$564.73	$1,139.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.57 / $395.63 / $516.54	Professional		$124.57	$395.63	$516.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $77.55 / $206.54 / $313.88	Facility		$77.55	$206.54	$313.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $156.29 / $250.89 / $327.52	Professional		$156.29	$250.89	$327.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.24 / $272.94 / $1,269.54	Facility		$134.24	$272.94	$1,269.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.78 / $181.56 / $297.20	Professional		$122.78	$181.56	$297.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $164.13	Professional		$50.00	$70.00	$164.13
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $77.55 / $206.54 / $313.88	Facility		$77.55	$206.54	$313.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $156.29 / $250.89 / $327.52	Professional		$156.29	$250.89	$327.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $272.94 / $420.05 / $720.66	Professional		$272.94	$420.05	$720.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $170.64 / $533.08 / $1,269.54	Facility		$170.64	$533.08	$1,269.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.57 / $170.64 / $1,431.39	Professional		$124.57	$170.64	$1,431.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $272.94 / $272.94 / $272.94	Professional		$272.94	$272.94	$272.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $217.95 / $272.94 / $272.94	Professional		$217.95	$272.94	$272.94
United Facility/Professional Professional Modifier Low / Median / High Price $108.57 / $158.74 / $272.94	Professional		$108.57	$158.74	$272.94