Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.78 / $92.78 / $92.78	Facility		$92.78	$92.78	$92.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.78 / $110.39 / $208.21	Professional		$92.78	$110.39	$208.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.91 / $202.30 / $334.72	Facility		$183.91	$202.30	$334.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.04 / $171.04 / $226.20	Professional		$171.04	$171.04	$226.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $132.30 / $393.57 / $393.57	Facility		$132.30	$393.57	$393.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.23 / $379.92 / $766.96	Facility		$126.23	$379.92	$766.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.15 / $266.72 / $348.06	Professional		$92.15	$266.72	$348.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $59.20 / $139.16 / $211.50	Facility		$59.20	$139.16	$211.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $183.91 / $220.69	Professional		$105.30	$183.91	$220.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $92.78 / $187.54 / $1,009.99	Facility		$92.78	$187.54	$1,009.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.26 / $106.98 / $200.26	Professional		$83.26	$106.98	$200.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $297.33	Professional		$50.00	$70.00	$297.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $59.20 / $139.16 / $211.50	Facility		$59.20	$139.16	$211.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $183.91 / $220.69	Professional		$105.30	$183.91	$220.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $183.91 / $283.02 / $550.03	Professional		$183.91	$283.02	$550.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $126.23 / $359.20 / $1,009.99	Facility		$126.23	$359.20	$1,009.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.15 / $126.23 / $1,176.33	Professional		$92.15	$126.23	$1,176.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $183.91 / $183.91 / $183.91	Professional		$183.91	$183.91	$183.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $183.91 / $183.91 / $183.91	Professional		$183.91	$183.91	$183.91
United Facility/Professional Professional Modifier Low / Median / High Price $71.80 / $91.85 / $171.77	Professional		$71.80	$91.85	$171.77