Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.82 / $139.82 / $17,823.00	Facility		$139.82	$139.82	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.82 / $163.36 / $220.11	Professional		$139.82	$163.36	$220.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.15 / $332.94 / $694.54	Professional		$157.15	$332.94	$694.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $172.12 / $260.39 / $260.39	Facility		$172.12	$260.39	$260.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $171.39 / $260.39 / $402.48	Professional		$171.39	$260.39	$402.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $139.82 / $169.60 / $351.01	Facility		$139.82	$169.60	$351.01
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $118.90 / $118.90 / $118.90	Professional		$118.90	$118.90	$118.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.82 / $169.60 / $351.01	Facility		$139.82	$169.60	$351.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $267.83 / $1,116.36 / $1,116.36	Professional		$267.83	$1,116.36	$1,116.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $587.91	Professional		$50.00	$65.00	$587.91
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $139.82 / $169.60 / $351.01	Facility		$139.82	$169.60	$351.01
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $118.90 / $118.90 / $118.90	Professional		$118.90	$118.90	$118.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $237.25 / $435.42 / $626.85	Professional		$237.25	$435.42	$626.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,062.89 / $5,062.89 / $5,062.89	Facility		$5,062.89	$5,062.89	$5,062.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $755.15 / $814.05 / $1,116.36	Professional		$755.15	$814.05	$1,116.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $332.38 / $332.38 / $332.38	Professional		$332.38	$332.38	$332.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $282.52 / $332.38 / $332.38	Professional		$282.52	$332.38	$332.38