Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.40 / $146.10 / $267.83	Facility		$75.40	$146.10	$267.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $75.40 / $146.86	Professional		$73.20	$75.40	$146.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.50 / $135.41 / $163.24	Facility		$91.50	$135.41	$163.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $73.20 / $98.82	Professional		$73.20	$73.20	$98.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.05 / $102.27 / $134.16	Facility		$73.05	$102.27	$134.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $73.20 / $169.71	Professional		$73.05	$73.20	$169.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.20 / $109.64 / $202.24	Facility		$73.20	$109.64	$202.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $87.71 / $145.44	Professional		$73.20	$87.71	$145.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $73.05 / $74.52 / $151.49	Facility		$73.05	$74.52	$151.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $40.35 / $146.40 / $146.40	Professional		$40.35	$146.40	$146.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.05 / $74.51 / $122.50	Facility		$73.05	$74.51	$122.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $81.31 / $2,022.25	Professional		$73.05	$81.31	$2,022.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $73.05 / $74.52 / $170.67	Facility		$73.05	$74.52	$170.67
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $40.35 / $146.40 / $146.40	Professional		$40.35	$146.40	$146.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $112.73 / $226.00	Professional		$73.20	$112.73	$226.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.20 / $85.00 / $381.80	Facility		$73.20	$85.00	$381.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $134.65 / $2,022.25	Professional		$73.20	$134.65	$2,022.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $101.47 / $102.77 / $128.38	Professional		$101.47	$102.77	$128.38
United Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $75.40 / $92.23	Professional		$73.20	$75.40	$92.23