Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $106.22 / $106.22	Facility		$106.22	$106.22	$106.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.22 / $125.84 / $242.55	Professional		$106.22	$125.84	$242.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.55 / $231.61 / $383.20	Facility		$210.55	$231.61	$383.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.81 / $195.81 / $258.97	Professional		$195.81	$195.81	$258.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.47 / $450.58 / $450.58	Facility		$151.47	$450.58	$450.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $435.28 / $878.93	Facility		$136.19	$435.28	$878.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.43 / $305.16 / $398.49	Professional		$99.43	$305.16	$398.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.95 / $159.33 / $242.13	Facility		$64.95	$159.33	$242.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $120.56 / $210.55 / $259.94	Professional		$120.56	$210.55	$259.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $210.55 / $1,062.92	Facility		$106.22	$210.55	$1,062.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $94.85 / $117.40 / $237.72	Professional		$94.85	$117.40	$237.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $91.22	Professional		$50.00	$65.00	$91.22
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.95 / $159.33 / $242.13	Facility		$64.95	$159.33	$242.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $120.56 / $210.55 / $259.94	Professional		$120.56	$210.55	$259.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $210.55 / $324.05 / $604.23	Professional		$210.55	$324.05	$604.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $411.24 / $1,062.92	Facility		$136.19	$411.24	$1,062.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $99.43 / $136.19 / $1,247.71	Professional		$99.43	$136.19	$1,247.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $210.55 / $210.55 / $210.55	Professional		$210.55	$210.55	$210.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $168.13 / $210.55 / $210.55	Professional		$168.13	$210.55	$210.55
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $111.71 / $201.33	Professional		$83.86	$111.71	$201.33