Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.13 / $134.13 / $134.13	Facility		$134.13	$134.13	$134.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.74 / $138.61 / $235.79	Professional		$129.74	$138.61	$235.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $231.02 / $231.02 / $381.18	Facility		$231.02	$231.02	$381.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.85 / $231.02 / $263.36	Professional		$214.85	$231.02	$263.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $231.02 / $494.38 / $494.38	Facility		$231.02	$494.38	$494.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $620.87 / $725.54 / $964.30	Facility		$620.87	$725.54	$964.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.26 / $334.69 / $437.24	Professional		$94.26	$334.69	$437.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $129.74 / $187.78 / $231.02	Facility		$129.74	$187.78	$231.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $128.26 / $128.26 / $231.02	Professional		$128.26	$128.26	$231.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.80 / $190.38 / $242.57	Facility		$131.80	$190.38	$242.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.57 / $128.26 / $433.10	Professional		$106.57	$128.26	$433.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $120.78	Professional		$50.00	$70.00	$120.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $129.74 / $190.38 / $231.02	Facility		$129.74	$190.38	$231.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $128.26 / $128.26 / $231.02	Professional		$128.26	$128.26	$231.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $231.02 / $346.53 / $607.00	Professional		$231.02	$346.53	$607.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $451.22 / $468.97 / $1,081.17	Facility		$451.22	$468.97	$1,081.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.26 / $1,015.25 / $1,540.67	Professional		$94.26	$1,015.25	$1,540.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $231.02 / $231.02 / $231.02	Professional		$231.02	$231.02	$231.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $231.02 / $231.02 / $231.02	Professional		$231.02	$231.02	$231.02
United Facility/Professional Professional Modifier Low / Median / High Price $81.64 / $115.25 / $192.09	Professional		$81.64	$115.25	$192.09