Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.53 / $167.53 / $17,823.00	Facility		$167.53	$167.53	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.53 / $195.53 / $258.17	Professional		$167.53	$195.53	$258.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.93 / $420.22 / $858.44	Professional		$183.93	$420.22	$858.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $206.40 / $312.24 / $312.24	Facility		$206.40	$312.24	$312.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $205.54 / $312.24 / $482.63	Professional		$205.54	$312.24	$482.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $167.53 / $203.18 / $420.93	Facility		$167.53	$203.18	$420.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $140.13 / $140.13	Professional		$140.13	$140.13	$140.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $167.53 / $203.18 / $420.93	Facility		$167.53	$203.18	$420.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $321.20 / $1,334.79 / $1,334.79	Professional		$321.20	$1,334.79	$1,334.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $689.23	Professional		$50.00	$65.00	$689.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $167.53 / $203.18 / $420.93	Facility		$167.53	$203.18	$420.93
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $140.13 / $140.13	Professional		$140.13	$140.13	$140.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $284.52 / $522.19 / $751.77	Professional		$284.52	$522.19	$751.77
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 $907.25 / $957.85 / $1,334.79	Professional		$907.25	$957.85	$1,334.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $390.18 / $390.18 / $390.18	Professional		$390.18	$390.18	$390.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $331.65 / $390.18 / $390.18	Professional		$331.65	$390.18	$390.18