Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.63 / $109.63 / $109.63	Facility		$109.63	$109.63	$109.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $93.52 / $121.26	Professional		$64.59	$93.52	$121.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $291.20 / $291.20	Facility		$160.00	$291.20	$291.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.77 / $148.80 / $215.95	Professional		$148.77	$148.80	$215.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.16 / $98.67 / $342.34	Facility		$13.16	$98.67	$342.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.30 / $100.30 / $396.49	Facility		$100.30	$100.30	$396.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.30 / $172.13 / $215.16	Professional		$100.30	$172.13	$215.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.10 / $146.32 / $210.34	Facility		$58.10	$146.32	$210.34
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $121.50 / $121.50 / $219.48	Professional		$121.50	$121.50	$219.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.10 / $219.48 / $719.88	Facility		$58.10	$219.48	$719.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.65 / $101.14 / $198.69	Professional		$75.65	$101.14	$198.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.67 / $72.90 / $99.63	Professional		$54.67	$72.90	$99.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $58.10 / $146.32 / $210.34	Facility		$58.10	$146.32	$210.34
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $121.50 / $121.50 / $219.48	Professional		$121.50	$121.50	$219.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.12 / $33.92 / $44.04	Professional		$21.12	$33.92	$44.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.30 / $310.62 / $719.88	Facility		$100.30	$310.62	$719.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.30 / $100.30 / $114.85	Professional		$100.30	$100.30	$114.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $174.71 / $174.71 / $174.71	Professional		$174.71	$174.71	$174.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $174.71 / $174.71 / $174.71	Professional		$174.71	$174.71	$174.71
United Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $101.14 / $196.74	Professional		$61.00	$101.14	$196.74