Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.80 / $97.80 / $97.80	Facility		$97.80	$97.80	$97.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $84.01 / $106.97	Professional		$57.00	$84.01	$106.97
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 / $134.29 / $194.92	Professional		$134.28	$134.29	$194.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.39 / $85.31 / $308.99	Facility		$11.39	$85.31	$308.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.16 / $88.16 / $361.35	Facility		$88.16	$88.16	$361.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.16 / $157.13 / $196.41	Professional		$88.16	$157.13	$196.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.22 / $126.52 / $181.87	Facility		$50.22	$126.52	$181.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $105.05 / $189.78	Professional		$105.05	$105.05	$189.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.22 / $189.78 / $632.74	Facility		$50.22	$189.78	$632.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.86 / $87.45 / $172.97	Professional		$65.86	$87.45	$172.97
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 $50.22 / $126.52 / $181.87	Facility		$50.22	$126.52	$181.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $105.05 / $189.78	Professional		$105.05	$105.05	$189.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $29.19 / $37.90	Professional		$19.05	$29.19	$37.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.16 / $280.36 / $632.74	Facility		$88.16	$280.36	$632.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.16 / $88.16 / $102.18	Professional		$88.16	$88.16	$102.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.28 / $152.28 / $152.28	Professional		$152.28	$152.28	$152.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.28 / $152.28 / $152.28	Professional		$152.28	$152.28	$152.28
United Facility/Professional Professional Modifier Low / Median / High Price $52.74 / $85.31 / $164.64	Professional		$52.74	$85.31	$164.64