Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.67 / $125.67 / $125.67	Facility		$125.67	$125.67	$125.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $112.00 / $141.97	Professional		$79.48	$112.00	$141.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $171.90 / $189.09 / $312.86	Facility		$171.90	$189.09	$312.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.87 / $159.88 / $211.46	Professional		$159.87	$159.88	$211.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.12 / $121.21 / $367.91	Facility		$12.12	$121.21	$367.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.30 / $206.74 / $702.58	Facility		$120.30	$206.74	$702.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.30 / $196.50 / $245.63	Professional		$120.30	$196.50	$245.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $171.92 / $206.30	Facility		$77.40	$171.92	$206.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $137.61 / $137.61 / $206.30	Professional		$137.61	$137.61	$206.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $226.21 / $812.03	Facility		$77.40	$226.21	$812.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.59 / $119.44 / $215.16	Professional		$87.59	$119.44	$215.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $152.59	Professional		$50.00	$65.00	$152.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $171.92 / $206.30	Facility		$77.40	$171.92	$206.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $137.61 / $137.61 / $206.30	Professional		$137.61	$137.61	$206.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.06 / $38.65 / $53.90	Professional		$21.06	$38.65	$53.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $120.30 / $333.82 / $812.03	Facility		$120.30	$333.82	$812.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.30 / $120.30 / $136.35	Professional		$120.30	$120.30	$136.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.16 / $215.16 / $215.16	Professional		$215.16	$215.16	$215.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.16 / $215.16 / $215.16	Professional		$215.16	$215.16	$215.16
United Facility/Professional Professional Modifier Low / Median / High Price $74.83 / $116.16 / $215.16	Professional		$74.83	$116.16	$215.16