Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $95.00 / $95.00	Facility		$95.00	$95.00	$95.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $98.58 / $179.33	Professional		$95.00	$98.58	$179.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.31 / $207.14 / $342.72	Facility		$188.31	$207.14	$342.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.47 / $175.13 / $231.62	Professional		$169.47	$175.13	$231.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $135.47 / $402.98 / $402.98	Facility		$135.47	$402.98	$402.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.82 / $389.31 / $786.56	Facility		$121.82	$389.31	$786.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $272.81 / $356.40	Professional		$88.93	$272.81	$356.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.83 / $142.50 / $216.56	Facility		$56.83	$142.50	$216.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $107.82 / $188.31 / $225.97	Professional		$107.82	$188.31	$225.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $188.31 / $928.37	Facility		$95.00	$188.31	$928.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.83 / $102.70 / $205.05	Professional		$84.83	$102.70	$205.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $68.95 / $114.93	Professional		$50.00	$68.95	$114.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.83 / $142.50 / $216.56	Facility		$56.83	$142.50	$216.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $107.82 / $188.31 / $225.97	Professional		$107.82	$188.31	$225.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $188.31 / $289.79 / $527.95	Professional		$188.31	$289.79	$527.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $121.82 / $367.80 / $928.37	Facility		$121.82	$367.80	$928.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $121.82 / $1,164.54	Professional		$88.93	$121.82	$1,164.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $188.31 / $188.31 / $188.31	Professional		$188.31	$188.31	$188.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $188.31 / $188.31 / $188.31	Professional		$188.31	$188.31	$188.31
United Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $97.88 / $188.31	Professional		$75.02	$97.88	$188.31