Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.28 / $152.36 / $174.99	Facility		$77.28	$152.36	$174.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $77.28 / $103.03	Professional		$75.03	$77.28	$103.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.79 / $138.79 / $167.29	Facility		$93.79	$138.79	$167.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.03 / $101.29	Professional		$75.03	$75.03	$101.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.03 / $106.65 / $137.52	Facility		$75.03	$106.65	$137.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $76.18 / $173.97	Professional		$75.03	$76.18	$173.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.02 / $104.33 / $216.88	Facility		$75.02	$104.33	$216.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $95.08 / $158.00	Professional		$75.02	$95.08	$158.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.03 / $77.28 / $188.53	Facility		$75.03	$77.28	$188.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $41.42 / $150.06 / $150.06	Professional		$41.42	$150.06	$150.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.18 / $76.94 / $124.67	Facility		$76.18	$76.94	$124.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $84.80 / $3,766.52	Professional		$76.18	$84.80	$3,766.52
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 $70.84 / $77.28 / $188.53	Facility		$70.84	$77.28	$188.53
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $41.42 / $150.06 / $150.06	Professional		$41.42	$150.06	$150.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $116.79 / $238.00	Professional		$75.03	$116.79	$238.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.02 / $105.97 / $498.40	Facility		$75.02	$105.97	$498.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $141.75 / $3,766.52	Professional		$75.02	$141.75	$3,766.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $76.18 / $76.18	Professional		$76.18	$76.18	$76.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.34 / $105.34 / $169.22	Professional		$105.34	$105.34	$169.22
United Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $78.78 / $94.54	Professional		$75.03	$78.78	$94.54