Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.53 / $101.53 / $101.53	Facility		$101.53	$101.53	$101.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.10 / $90.25 / $114.69	Professional		$61.10	$90.25	$114.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.19 / $275.18 / $275.18	Facility		$151.19	$275.18	$275.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.62 / $140.63 / $204.12	Professional		$140.62	$140.63	$204.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.66 / $106.61 / $343.00	Facility		$10.66	$106.61	$343.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.52 / $93.52 / $397.39	Facility		$93.52	$93.52	$397.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.52 / $172.50 / $215.63	Professional		$93.52	$172.50	$215.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.88 / $128.22 / $184.32	Facility		$43.88	$128.22	$184.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $91.76 / $91.76 / $192.34	Professional		$91.76	$91.76	$192.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.88 / $192.34 / $671.25	Facility		$43.88	$192.34	$671.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.55 / $85.14 / $180.30	Professional		$62.55	$85.14	$180.30
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 $43.88 / $128.22 / $184.32	Facility		$43.88	$128.22	$184.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $91.76 / $91.76 / $192.34	Professional		$91.76	$91.76	$192.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.96 / $30.76 / $39.94	Professional		$19.96	$30.76	$39.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $93.52 / $293.64 / $671.25	Facility		$93.52	$293.64	$671.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.52 / $93.52 / $122.74	Professional		$93.52	$93.52	$122.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $158.13 / $158.13 / $158.13	Professional		$158.13	$158.13	$158.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $158.13 / $158.13 / $158.13	Professional		$158.13	$158.13	$158.13
United Facility/Professional Professional Modifier Low / Median / High Price $57.21 / $80.09 / $182.18	Professional		$57.21	$80.09	$182.18