Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.09 / $142.09 / $142.09	Facility		$142.09	$142.09	$142.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.07 / $131.22 / $172.46	Professional		$92.07	$131.22	$172.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.50 / $388.57 / $388.57	Facility		$213.50	$388.57	$388.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.33 / $198.56 / $288.22	Professional		$198.33	$198.56	$288.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.35 / $115.06 / $456.38	Facility		$15.35	$115.06	$456.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.41 / $134.41 / $588.42	Facility		$134.41	$134.41	$588.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.41 / $253.88 / $317.33	Professional		$134.41	$253.88	$317.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $59.91 / $142.09 / $255.76	Facility		$59.91	$142.09	$255.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $125.30 / $125.30 / $255.91	Professional		$125.30	$125.30	$255.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.91 / $255.91 / $997.78	Facility		$59.91	$255.91	$997.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $108.27 / $243.74	Professional		$85.80	$108.27	$243.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $120.52	Professional		$50.00	$65.00	$120.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $59.91 / $142.09 / $255.76	Facility		$59.91	$142.09	$255.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $125.30 / $125.30 / $255.91	Professional		$125.30	$125.30	$255.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $43.38 / $56.33	Professional		$28.18	$43.38	$56.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $134.41 / $416.52 / $997.78	Facility		$134.41	$416.52	$997.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.41 / $134.41 / $154.66	Professional		$134.41	$134.41	$154.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $213.26 / $213.26 / $213.26	Professional		$213.26	$213.26	$213.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $213.26 / $213.26 / $213.26	Professional		$213.26	$213.26	$213.26
United Facility/Professional Professional Modifier Low / Median / High Price $77.34 / $122.63 / $218.84	Professional		$77.34	$122.63	$218.84