Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.98 / $70.98 / $70.98	Facility		$70.98	$70.98	$70.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $85.68 / $157.32	Professional		$70.98	$85.68	$157.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $119.94 / $131.93 / $218.29	Facility		$119.94	$131.93	$218.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.54 / $119.07 / $147.52	Professional		$111.54	$119.07	$147.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.85 / $256.67 / $256.67	Facility		$140.85	$256.67	$256.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $411.00 / $575.22	Facility		$133.72	$411.00	$575.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $198.58 / $225.66	Professional		$97.62	$198.58	$225.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $109.16 / $143.93	Facility		$63.06	$109.16	$143.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $112.11 / $143.93	Professional		$62.23	$112.11	$143.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.98 / $143.93 / $620.42	Facility		$70.98	$143.93	$620.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.69 / $112.89 / $182.98	Professional		$88.69	$112.89	$182.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $130.60	Professional		$50.00	$70.00	$130.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $119.94 / $143.93	Facility		$63.06	$119.94	$143.93
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $112.11 / $143.93	Professional		$62.23	$112.11	$143.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $119.94 / $145.93 / $252.81	Professional		$119.94	$145.93	$252.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $232.88 / $620.42	Facility		$133.72	$232.88	$620.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $133.72 / $1,040.40	Professional		$97.62	$133.72	$1,040.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $168.54 / $168.54 / $168.54	Professional		$168.54	$168.54	$168.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $168.54 / $168.54 / $168.54	Professional		$168.54	$168.54	$168.54
United Facility/Professional Professional Modifier Low / Median / High Price $75.26 / $101.12 / $167.92	Professional		$75.26	$101.12	$167.92