Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $255.18 / $255.18 / $255.18	Facility		$255.18	$255.18	$255.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $107.56 / $107.56	Professional		$91.54	$107.56	$107.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.02 / $297.52 / $314.68	Facility		$246.02	$297.52	$314.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.77 / $97.26 / $473.46	Professional		$45.77	$97.26	$473.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $174.23 / $279.66 / $279.66	Facility		$174.23	$279.66	$279.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $314.49 / $367.51 / $563.77	Facility		$314.49	$367.51	$563.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.69 / $308.13 / $350.15	Professional		$135.69	$308.13	$350.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $88.11 / $137.32 / $400.51	Facility		$88.11	$137.32	$400.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $114.43 / $114.43	Professional		$114.43	$114.43	$114.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.99 / $137.32 / $400.51	Facility		$102.99	$137.32	$400.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.22 / $73.27 / $352.88	Professional		$57.22	$73.27	$352.88
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 $88.11 / $137.32 / $400.51	Facility		$88.11	$137.32	$400.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $114.43 / $114.43	Professional		$114.43	$114.43	$114.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $167.34 / $272.58 / $382.96	Professional		$167.34	$272.58	$382.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $228.86 / $543.54 / $543.54	Facility		$228.86	$543.54	$543.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $457.72 / $572.15 / $572.15	Professional		$457.72	$572.15	$572.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $243.68 / $243.68 / $243.68	Professional		$243.68	$243.68	$243.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $332.56 / $624.79 / $624.79	Professional		$332.56	$624.79	$624.79
United Facility/Professional Professional Modifier Low / Median / High Price $49.74 / $68.66 / $205.97	Professional		$49.74	$68.66	$205.97