Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.16 / $149.16 / $149.16	Facility		$149.16	$149.16	$149.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.98 / $133.04 / $178.25	Professional		$89.98	$133.04	$178.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.60 / $354.17 / $354.17	Facility		$194.60	$354.17	$354.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.94 / $194.56 / $262.64	Professional		$180.94	$194.56	$262.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $137.16 / $509.58	Facility		$22.91	$137.16	$509.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.59 / $123.59 / $512.74	Facility		$123.59	$123.59	$512.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.59 / $222.38 / $277.97	Professional		$123.59	$222.38	$277.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $100.84 / $253.97 / $365.08	Facility		$100.84	$253.97	$365.08
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $179.26 / $179.26 / $380.95	Professional		$179.26	$179.26	$380.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $149.16 / $317.45 / $886.11	Facility		$149.16	$317.45	$886.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.38 / $171.26 / $279.70	Professional		$108.38	$171.26	$279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $90.00 / $143.71	Professional		$55.00	$90.00	$143.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $100.84 / $253.97 / $365.08	Facility		$100.84	$253.97	$365.08
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $179.26 / $179.26 / $380.95	Professional		$179.26	$179.26	$380.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.69 / $39.44 / $51.21	Professional		$25.69	$39.44	$51.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $123.59 / $377.80 / $886.11	Facility		$123.59	$377.80	$886.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.59 / $123.59 / $155.94	Professional		$123.59	$123.59	$155.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $260.77 / $260.77 / $260.77	Professional		$260.77	$260.77	$260.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $260.77 / $260.77 / $260.77	Professional		$260.77	$260.77	$260.77
United Facility/Professional Professional Modifier Low / Median / High Price $95.59 / $147.91 / $267.89	Professional		$95.59	$147.91	$267.89