Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.67 / $170.50 / $13,411.18	Facility		$87.67	$170.50	$13,411.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.12 / $87.67 / $116.89	Professional		$85.12	$87.67	$116.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.40 / $157.47 / $189.82	Facility		$106.40	$157.47	$189.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.12 / $85.12 / $114.91	Professional		$85.12	$85.12	$114.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.12 / $119.17 / $156.02	Facility		$85.12	$119.17	$156.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.12 / $85.25 / $197.36	Professional		$85.12	$85.25	$197.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.12 / $109.50 / $227.64	Facility		$85.12	$109.50	$227.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.12 / $101.98 / $158.47	Professional		$85.12	$101.98	$158.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.12 / $85.25 / $94.76	Facility		$85.12	$85.25	$94.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $127.88 / $170.24 / $170.24	Professional		$127.88	$170.24	$170.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.25 / $85.25 / $100.03	Facility		$85.25	$85.25	$100.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.25 / $94.90 / $370.33	Professional		$85.25	$94.90	$370.33
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 $85.12 / $85.25 / $94.12	Facility		$85.12	$85.25	$94.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $127.88 / $170.24 / $170.24	Professional		$127.88	$170.24	$170.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.12 / $111.32 / $284.89	Professional		$85.12	$111.32	$284.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $85.12 / $85.12 / $419.35	Facility		$85.12	$85.12	$419.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.12 / $154.30 / $370.33	Professional		$85.12	$154.30	$370.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $119.51 / $119.51 / $119.51	Professional		$119.51	$119.51	$119.51
United Facility/Professional Professional Modifier Low / Median / High Price $85.12 / $93.63 / $193.48	Professional		$85.12	$93.63	$193.48