Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $184.80 / $184.80 / $184.80	Facility		$184.80	$184.80	$184.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.85 / $184.80 / $316.50	Professional		$156.85	$184.80	$316.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $366.32 / $402.95 / $666.70	Facility		$366.32	$402.95	$666.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.68 / $340.68 / $450.57	Professional		$340.68	$340.68	$450.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $263.54 / $783.92 / $783.92	Facility		$263.54	$783.92	$783.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.90 / $984.92 / $1,529.72	Facility		$228.90	$984.92	$1,529.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.57 / $539.12 / $693.28	Professional		$194.57	$539.12	$693.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $117.98 / $277.20 / $421.27	Facility		$117.98	$277.20	$421.27
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $209.74 / $366.32 / $439.58	Professional		$209.74	$366.32	$439.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $184.80 / $366.32 / $1,907.92	Facility		$184.80	$366.32	$1,907.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $170.32 / $244.76 / $402.95	Professional		$170.32	$244.76	$402.95
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 $117.98 / $282.74 / $421.27	Facility		$117.98	$282.74	$421.27
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $209.74 / $366.32 / $439.58	Professional		$209.74	$366.32	$439.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $366.32 / $563.75 / $1,096.04	Professional		$366.32	$563.75	$1,096.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $228.90 / $715.46 / $1,907.92	Facility		$228.90	$715.46	$1,907.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $194.57 / $228.90 / $2,432.33	Professional		$194.57	$228.90	$2,432.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $366.32 / $366.32 / $366.32	Professional		$366.32	$366.32	$366.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $366.32 / $366.32 / $366.32	Professional		$366.32	$366.32	$366.32
United Facility/Professional Professional Modifier Low / Median / High Price $145.94 / $219.79 / $366.32	Professional		$145.94	$219.79	$366.32