Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.63 / $70.63 / $70.63	Facility		$70.63	$70.63	$70.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.63 / $72.00 / $148.47	Professional		$70.63	$72.00	$148.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.35 / $124.69 / $206.30	Facility		$113.35	$124.69	$206.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.42 / $105.42 / $139.41	Professional		$105.42	$105.42	$139.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $153.40 / $242.57 / $242.57	Facility		$153.40	$242.57	$242.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.17 / $388.00 / $543.03	Facility		$52.17	$388.00	$543.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $187.68 / $213.28	Professional		$38.08	$187.68	$213.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.81 / $105.95 / $130.91	Facility		$28.81	$105.95	$130.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $58.82 / $113.35 / $136.02	Professional		$58.82	$113.35	$136.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.63 / $130.91 / $580.79	Facility		$70.63	$130.91	$580.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.03 / $117.73 / $203.90	Professional		$95.03	$117.73	$203.90
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 $28.81 / $105.95 / $130.91	Facility		$28.81	$105.95	$130.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $58.82 / $113.35 / $136.02	Professional		$58.82	$113.35	$136.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $113.10 / $137.25 / $191.40	Professional		$113.10	$137.25	$191.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $52.17 / $220.10 / $580.79	Facility		$52.17	$220.10	$580.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $52.17 / $886.50	Professional		$38.08	$52.17	$886.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.38 / $173.38 / $173.38	Professional		$173.38	$173.38	$173.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.38 / $173.38 / $173.38	Professional		$173.38	$173.38	$173.38
United Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $117.73 / $203.90	Professional		$79.19	$117.73	$203.90