Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.78 / $216.06 / $248.13	Facility		$98.78	$216.06	$248.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $98.78 / $162.05	Professional		$95.90	$98.78	$162.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $119.88 / $177.42 / $213.86	Facility		$119.88	$177.42	$213.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $129.46	Professional		$95.90	$95.90	$129.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $153.44 / $172.62 / $175.78	Facility		$153.44	$172.62	$175.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $205.50 / $427.21	Facility		$95.90	$205.50	$427.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $200.11 / $290.64	Professional		$95.90	$200.11	$290.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $105.49 / $739.57	Facility		$95.90	$105.49	$739.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $162.05 / $191.80 / $1,096.93	Professional		$162.05	$191.80	$1,096.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.03 / $111.27 / $739.57	Facility		$108.03	$111.27	$739.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.03 / $120.26 / $5,879.42	Professional		$108.03	$120.26	$5,879.42
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 $95.90 / $106.05 / $739.57	Facility		$95.90	$106.05	$739.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $162.05 / $191.80 / $1,096.93	Professional		$162.05	$191.80	$1,096.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $161.97 / $469.00	Professional		$95.90	$161.97	$469.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $95.90 / $2,009.53	Facility		$95.90	$95.90	$2,009.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $280.50 / $5,879.42	Professional		$95.90	$280.50	$5,879.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.63 / $134.63 / $1,272.63	Professional		$134.63	$134.63	$1,272.63
United Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $101.65 / $161.81	Professional		$95.90	$101.65	$161.81