Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.45 / $98.45 / $98.45	Facility		$98.45	$98.45	$98.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.16 / $98.45 / $176.91	Professional		$93.16	$98.45	$176.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $195.15 / $214.67 / $355.17	Facility		$195.15	$214.67	$355.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.49 / $181.49 / $240.03	Professional		$181.49	$181.49	$240.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.40 / $417.62 / $417.62	Facility		$140.40	$417.62	$417.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.22 / $430.79 / $814.55	Facility		$112.22	$430.79	$814.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.92 / $325.02 / $369.35	Professional		$81.92	$325.02	$369.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.16 / $147.68 / $224.42	Facility		$56.16	$147.68	$224.42
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $111.74 / $190.45 / $234.18	Professional		$111.74	$190.45	$234.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.21 / $195.15 / $908.81	Facility		$97.21	$195.15	$908.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.20 / $102.23 / $212.50	Professional		$85.20	$102.23	$212.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $131.69	Professional		$50.00	$65.00	$131.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.16 / $147.68 / $224.42	Facility		$56.16	$147.68	$224.42
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $111.74 / $190.45 / $234.18	Professional		$111.74	$190.45	$234.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $195.15 / $300.33 / $521.91	Professional		$195.15	$300.33	$521.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $112.22 / $381.16 / $908.81	Facility		$112.22	$381.16	$908.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.92 / $112.22 / $984.25	Professional		$81.92	$112.22	$984.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $195.15 / $195.15 / $195.15	Professional		$195.15	$195.15	$195.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $155.83 / $195.15 / $195.15	Professional		$155.83	$195.15	$195.15
United Facility/Professional Professional Modifier Low / Median / High Price $72.48 / $97.36 / $195.15	Professional		$72.48	$97.36	$195.15