Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.97 / $119.97 / $119.97	Facility		$119.97	$119.97	$119.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.68 / $108.93 / $142.77	Professional		$73.68	$108.93	$142.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.40 / $167.64 / $277.37	Facility		$152.40	$167.64	$277.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.72 / $141.75 / $187.47	Professional		$141.72	$141.75	$187.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.74 / $107.46 / $326.18	Facility		$10.74	$107.46	$326.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.50 / $134.41 / $641.00	Facility		$123.50	$134.41	$641.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $179.25 / $224.06	Professional		$104.98	$179.25	$224.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.93 / $152.41 / $199.84	Facility		$84.93	$152.41	$199.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $177.63 / $177.63 / $182.90	Professional		$177.63	$177.63	$182.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.93 / $215.95 / $725.63	Facility		$84.93	$215.95	$725.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.15 / $124.33 / $222.04	Professional		$79.15	$124.33	$222.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $134.54	Professional		$50.00	$65.00	$134.54
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $84.93 / $152.41 / $199.84	Facility		$84.93	$152.41	$199.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $177.63 / $177.63 / $182.90	Professional		$177.63	$177.63	$182.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.19 / $31.55 / $44.00	Professional		$17.19	$31.55	$44.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $123.50 / $295.95 / $725.63	Facility		$123.50	$295.95	$725.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $123.50 / $123.50	Professional		$104.98	$123.50	$123.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.94 / $215.94 / $215.94	Professional		$215.94	$215.94	$215.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.94 / $215.94 / $215.94	Professional		$215.94	$215.94	$215.94
United Facility/Professional Professional Modifier Low / Median / High Price $59.49 / $118.98 / $222.04	Professional		$59.49	$118.98	$222.04