Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.06 / $125.06 / $5,850.00	Facility		$125.06	$125.06	$5,850.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.10 / $142.53 / $232.26	Professional		$115.10	$142.53	$232.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $247.92 / $272.70 / $451.21	Facility		$247.92	$272.70	$451.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.57 / $230.57 / $304.94	Professional		$230.57	$230.57	$304.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $178.35 / $530.54 / $530.54	Facility		$178.35	$530.54	$530.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.78 / $665.93 / $1,034.28	Facility		$195.78	$665.93	$1,034.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.41 / $412.91 / $469.21	Professional		$166.41	$412.91	$469.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $76.44 / $187.59 / $285.11	Facility		$76.44	$187.59	$285.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $141.97 / $247.92 / $297.50	Professional		$141.97	$247.92	$297.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $125.06 / $247.92 / $1,140.98	Facility		$125.06	$247.92	$1,140.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.28 / $165.67 / $273.27	Professional		$115.28	$165.67	$273.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $158.03	Professional		$50.00	$70.00	$158.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $76.44 / $187.59 / $285.11	Facility		$76.44	$187.59	$285.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $141.97 / $247.92 / $297.50	Professional		$141.97	$247.92	$297.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $247.92 / $381.55 / $710.62	Professional		$247.92	$381.55	$710.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $195.78 / $484.22 / $1,140.98	Facility		$195.78	$484.22	$1,140.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $166.41 / $195.78 / $1,327.05	Professional		$166.41	$195.78	$1,327.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $247.92 / $247.92 / $247.92	Professional		$247.92	$247.92	$247.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $247.92 / $247.92 / $247.92	Professional		$247.92	$247.92	$247.92
United Facility/Professional Professional Modifier Low / Median / High Price $98.67 / $156.46 / $219.81	Professional		$98.67	$156.46	$219.81