Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.08 / $86.08 / $131.40	Facility		$86.08	$86.08	$131.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $86.08 / $155.38	Professional		$81.81	$86.08	$155.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.64 / $187.70 / $310.56	Facility		$170.64	$187.70	$310.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.59 / $158.69 / $209.88	Professional		$147.59	$158.69	$209.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $122.77 / $365.17 / $365.17	Facility		$122.77	$365.17	$365.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.38 / $352.72 / $712.38	Facility		$115.38	$352.72	$712.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.23 / $247.50 / $322.95	Professional		$84.23	$247.50	$322.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $46.07 / $128.26 / $196.24	Facility		$46.07	$128.26	$196.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $97.70 / $170.64 / $204.77	Professional		$97.70	$170.64	$204.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.73 / $170.64 / $749.92	Facility		$79.73	$170.64	$749.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $85.13 / $185.81	Professional		$67.98	$85.13	$185.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $46.07 / $129.12 / $196.24	Facility		$46.07	$129.12	$196.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $97.70 / $170.64 / $204.77	Professional		$97.70	$170.64	$204.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $170.64 / $256.20 / $428.58	Professional		$170.64	$256.20	$428.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $115.38 / $333.28 / $749.92	Facility		$115.38	$333.28	$749.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $84.23 / $115.38 / $860.74	Professional		$84.23	$115.38	$860.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $170.64 / $170.64 / $170.64	Professional		$170.64	$170.64	$170.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $170.64 / $170.64 / $170.64	Professional		$170.64	$170.64	$170.64
United Facility/Professional Professional Modifier Low / Median / High Price $59.47 / $85.13 / $170.64	Professional		$59.47	$85.13	$170.64