Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.63 / $114.63 / $114.63	Facility		$114.63	$114.63	$114.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.63 / $131.27 / $241.01	Professional		$114.63	$131.27	$241.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $184.14 / $202.55 / $335.13	Facility		$184.14	$202.55	$335.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.25 / $184.14 / $230.17	Professional		$171.25	$184.14	$230.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $248.56 / $394.06 / $394.06	Facility		$248.56	$394.06	$394.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.82 / $683.87 / $883.12	Facility		$211.82	$683.87	$883.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $304.89 / $346.46	Professional		$154.63	$304.89	$346.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $69.56 / $171.95 / $220.97	Facility		$69.56	$171.95	$220.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $184.14 / $220.97	Professional		$95.54	$184.14	$220.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.63 / $212.66 / $943.35	Facility		$114.63	$212.66	$943.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.02 / $181.22 / $330.37	Professional		$154.02	$181.22	$330.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $328.25	Professional		$50.00	$70.00	$328.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $69.56 / $173.05 / $220.97	Facility		$69.56	$173.05	$220.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $184.14 / $220.97	Professional		$95.54	$184.14	$220.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $184.14 / $223.23 / $421.82	Professional		$184.14	$223.23	$421.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $211.82 / $357.54 / $943.35	Facility		$211.82	$357.54	$943.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $211.82 / $1,436.40	Professional		$154.63	$211.82	$1,436.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $281.20 / $281.20 / $281.20	Professional		$281.20	$281.20	$281.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $281.20 / $281.20 / $281.20	Professional		$281.20	$281.20	$281.20
United Facility/Professional Professional Modifier Low / Median / High Price $128.35 / $179.69 / $296.33	Professional		$128.35	$179.69	$296.33