Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.08 / $105.08 / $105.08	Facility		$105.08	$105.08	$105.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.50 / $95.29 / $124.73	Professional		$68.50	$95.29	$124.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.69 / $147.07 / $243.33	Facility		$133.69	$147.07	$243.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.29 / $124.34 / $167.12	Professional		$124.29	$124.34	$167.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.42 / $94.21 / $285.99	Facility		$9.42	$94.21	$285.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.60 / $198.33 / $561.23	Facility		$96.60	$198.33	$561.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $156.75 / $195.94	Professional		$96.60	$156.75	$195.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.26 / $133.63 / $174.73	Facility		$74.26	$133.63	$174.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $141.47 / $160.37	Professional		$141.47	$141.47	$160.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.26 / $160.37 / $652.11	Facility		$74.26	$160.37	$652.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.59 / $108.70 / $194.14	Professional		$71.59	$108.70	$194.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.72 / $58.40 / $119.57	Professional		$0.72	$58.40	$119.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $74.26 / $133.63 / $174.73	Facility		$74.26	$133.63	$174.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $141.47 / $160.37	Professional		$141.47	$141.47	$160.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.90 / $29.19 / $40.70	Professional		$15.90	$29.19	$40.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $96.60 / $259.50 / $652.11	Facility		$96.60	$259.50	$652.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $96.60 / $111.16	Professional		$96.60	$96.60	$111.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $191.29 / $191.29 / $191.29	Professional		$191.29	$191.29	$191.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $191.29 / $191.29 / $191.29	Professional		$191.29	$191.29	$191.29
United Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $108.70 / $194.14	Professional		$67.14	$108.70	$194.14