Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.71 / $137.71 / $137.71	Facility		$137.71	$137.71	$137.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $119.79 / $157.81	Professional		$87.41	$119.79	$157.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $205.00 / $373.10 / $373.10	Facility		$205.00	$373.10	$373.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.60 / $190.65 / $276.68	Professional		$190.60	$190.65	$276.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.66 / $117.53 / $438.59	Facility		$15.66	$117.53	$438.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.15 / $83.15 / $599.04	Facility		$83.15	$83.15	$599.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.68 / $228.75 / $285.94	Professional		$70.68	$228.75	$285.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $143.63 / $187.85 / $250.57	Facility		$143.63	$187.85	$250.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $261.47 / $261.47 / $261.47	Professional		$261.47	$261.47	$261.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $143.63 / $250.57 / $970.44	Facility		$143.63	$250.57	$970.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.63 / $115.08 / $255.36	Professional		$84.63	$115.08	$255.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $121.03	Professional		$50.00	$65.00	$121.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $137.71 / $206.57 / $250.57	Facility		$137.71	$206.57	$250.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $261.47 / $261.47 / $261.47	Professional		$261.47	$261.47	$261.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.06 / $45.75 / $59.40	Professional		$27.06	$45.75	$59.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.15 / $397.96 / $970.44	Facility		$83.15	$397.96	$970.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.14 / $83.14 / $83.15	Professional		$83.14	$83.14	$83.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $217.87 / $217.87 / $217.87	Professional		$217.87	$217.87	$217.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $217.87 / $217.87 / $217.87	Professional		$217.87	$217.87	$217.87
United Facility/Professional Professional Modifier Low / Median / High Price $81.02 / $126.56 / $243.06	Professional		$81.02	$126.56	$243.06