Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.98 / $123.98 / $123.98	Facility		$123.98	$123.98	$123.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.39 / $112.91 / $147.11	Professional		$78.39	$112.91	$147.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.20 / $317.04 / $317.04	Facility		$174.20	$317.04	$317.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.97 / $174.17 / $236.82	Professional		$161.97	$174.17	$236.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.32 / $122.44 / $372.72	Facility		$16.32	$122.44	$372.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.51 / $115.51 / $473.09	Facility		$115.51	$115.51	$473.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.51 / $205.50 / $256.88	Professional		$115.51	$205.50	$256.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $123.98 / $181.53 / $260.95	Facility		$123.98	$181.53	$260.95
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $150.72 / $150.72 / $272.29	Professional		$150.72	$150.72	$272.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.98 / $272.29 / $829.11	Facility		$123.98	$272.29	$829.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.40 / $122.88 / $227.81	Professional		$90.40	$122.88	$227.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $165.71	Professional		$50.00	$65.00	$165.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $123.98 / $185.97 / $260.95	Facility		$123.98	$185.97	$260.95
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $150.72 / $150.72 / $272.29	Professional		$150.72	$150.72	$272.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.99 / $38.65 / $50.19	Professional		$22.99	$38.65	$50.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $115.51 / $338.20 / $829.11	Facility		$115.51	$338.20	$829.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.51 / $115.51 / $151.61	Professional		$115.51	$115.51	$151.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $208.45 / $208.45 / $208.45	Professional		$208.45	$208.45	$208.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $208.45 / $208.45 / $208.45	Professional		$208.45	$208.45	$208.45
United Facility/Professional Professional Modifier Low / Median / High Price $77.40 / $122.39 / $216.84	Professional		$77.40	$122.39	$216.84