Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.90 / $127.90 / $127.90	Facility		$127.90	$127.90	$127.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $111.36 / $146.50	Professional		$78.06	$111.36	$146.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.10 / $333.24 / $333.24	Facility		$183.10	$333.24	$333.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.25 / $170.28 / $247.13	Professional		$170.25	$170.28	$247.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.11 / $120.85 / $391.75	Facility		$16.11	$120.85	$391.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.47 / $114.47 / $466.78	Facility		$114.47	$114.47	$466.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.47 / $202.50 / $253.13	Professional		$114.47	$202.50	$253.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $179.19 / $257.58	Facility		$108.00	$179.19	$257.58
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $148.80 / $268.79	Professional		$148.80	$148.80	$268.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $268.79 / $821.01	Facility		$108.00	$268.79	$821.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.24 / $123.44 / $228.68	Professional		$89.24	$123.44	$228.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $90.00 / $134.14	Professional		$55.00	$90.00	$134.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $191.85 / $257.58	Facility		$108.00	$191.85	$257.58
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $148.80 / $268.79	Professional		$148.80	$148.80	$268.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.17 / $38.65 / $50.19	Professional		$24.17	$38.65	$50.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $114.47 / $355.46 / $821.01	Facility		$114.47	$355.46	$821.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.47 / $114.47 / $150.25	Professional		$114.47	$114.47	$150.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $206.87 / $206.87 / $206.87	Professional		$206.87	$206.87	$206.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $206.87 / $206.87 / $206.87	Professional		$206.87	$206.87	$206.87
United Facility/Professional Professional Modifier Low / Median / High Price $74.70 / $120.95 / $228.68	Professional		$74.70	$120.95	$228.68