Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.12 / $99.12 / $99.12	Facility		$99.12	$99.12	$99.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.25 / $88.58 / $116.83	Professional		$62.25	$88.58	$116.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.40 / $262.81 / $262.81	Facility		$144.40	$262.81	$262.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.28 / $144.38 / $194.92	Professional		$134.28	$144.38	$194.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.96 / $89.62 / $308.99	Facility		$11.96	$89.62	$308.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.65 / $94.65 / $382.07	Facility		$94.65	$94.65	$382.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.65 / $165.75 / $207.19	Professional		$94.65	$165.75	$207.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $87.00 / $132.90 / $191.04	Facility		$87.00	$132.90	$191.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $110.34 / $110.34 / $199.34	Professional		$110.34	$110.34	$199.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.00 / $199.34 / $679.35	Facility		$87.00	$199.34	$679.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.27 / $91.86 / $185.37	Professional		$69.27	$91.86	$185.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $87.00 / $140.69 / $191.04	Facility		$87.00	$140.69	$191.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $110.34 / $110.34 / $199.34	Professional		$110.34	$110.34	$199.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $31.55 / $40.97	Professional		$19.05	$31.55	$40.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $94.65 / $280.38 / $679.35	Facility		$94.65	$280.38	$679.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.65 / $94.65 / $124.23	Professional		$94.65	$94.65	$124.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $161.83 / $161.83 / $161.83	Professional		$161.83	$161.83	$161.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $161.83 / $161.83 / $161.83	Professional		$161.83	$161.83	$161.83
United Facility/Professional Professional Modifier Low / Median / High Price $58.82 / $94.46 / $177.89	Professional		$58.82	$94.46	$177.89