Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.85 / $143.85 / $143.85	Facility		$143.85	$143.85	$143.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.46 / $129.22 / $164.15	Professional		$87.46	$129.22	$164.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.80 / $380.02 / $380.02	Facility		$208.80	$380.02	$380.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.17 / $194.18 / $281.86	Professional		$194.17	$194.18	$281.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.50 / $131.26 / $446.81	Facility		$17.50	$131.26	$446.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.68 / $130.68 / $555.99	Facility		$130.68	$130.68	$555.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.68 / $241.50 / $301.88	Professional		$130.68	$241.50	$301.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $133.96 / $194.65 / $279.81	Facility		$133.96	$194.65	$279.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $291.97 / $291.97 / $291.97	Professional		$291.97	$291.97	$291.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.96 / $258.93 / $937.40	Facility		$133.96	$258.93	$937.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.39 / $119.24 / $253.80	Professional		$95.39	$119.24	$253.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $90.00 / $145.70	Professional		$55.00	$90.00	$145.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $133.96 / $194.65 / $279.81	Facility		$133.96	$194.65	$279.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $291.97 / $291.97 / $291.97	Professional		$291.97	$291.97	$291.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $43.38 / $56.33	Professional		$27.56	$43.38	$56.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $130.68 / $405.42 / $937.40	Facility		$130.68	$405.42	$937.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $130.68 / $130.68 / $171.51	Professional		$130.68	$130.68	$171.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $230.47 / $230.47 / $230.47	Professional		$230.47	$230.47	$230.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $230.47 / $230.47 / $230.47	Professional		$230.47	$230.47	$230.47
United Facility/Professional Professional Modifier Low / Median / High Price $80.53 / $119.24 / $241.58	Professional		$80.53	$119.24	$241.58