Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.35 / $92.35 / $92.35	Facility		$92.35	$92.35	$92.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.03 / $84.14 / $110.78	Professional		$59.03	$84.14	$110.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.20 / $227.86 / $227.86	Facility		$125.20	$227.86	$227.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.42 / $125.18 / $169.02	Professional		$116.42	$125.18	$169.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.14 / $88.25 / $293.02	Facility		$13.14	$88.25	$293.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.62 / $81.62 / $340.62	Facility		$81.62	$81.62	$340.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.62 / $147.75 / $184.69	Professional		$81.62	$147.75	$184.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $146.03 / $209.92	Facility		$79.00	$146.03	$209.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $121.27 / $121.27 / $219.05	Professional		$121.27	$121.27	$219.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $92.35 / $200.73 / $585.33	Facility		$92.35	$200.73	$585.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.67 / $98.48 / $167.83	Professional		$68.67	$98.48	$167.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $133.32	Professional		$50.00	$65.00	$133.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $146.03 / $209.92	Facility		$79.00	$146.03	$209.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $121.27 / $121.27 / $219.05	Professional		$121.27	$121.27	$219.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.53 / $26.03 / $33.79	Professional		$16.53	$26.03	$33.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $81.62 / $243.08 / $585.33	Facility		$81.62	$243.08	$585.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.62 / $81.62 / $109.27	Professional		$81.62	$81.62	$109.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $158.36 / $158.36 / $158.36	Professional		$158.36	$158.36	$158.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $158.36 / $158.36 / $158.36	Professional		$158.36	$158.36	$158.36
United Facility/Professional Professional Modifier Low / Median / High Price $60.88 / $91.56 / $165.83	Professional		$60.88	$91.56	$165.83