Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.87 / $90.87 / $90.87	Facility		$90.87	$90.87	$90.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.87 / $114.06 / $216.63	Professional		$90.87	$114.06	$216.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.14 / $198.15 / $327.85	Facility		$180.14	$198.15	$327.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.80 / $167.53 / $221.57	Professional		$155.80	$167.53	$221.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $129.59 / $385.50 / $385.50	Facility		$129.59	$385.50	$385.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.53 / $372.43 / $751.57	Facility		$116.53	$372.43	$751.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $300.02 / $340.94	Professional		$85.07	$300.02	$340.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.02 / $135.40 / $207.16	Facility		$58.02	$135.40	$207.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $103.14 / $180.14 / $216.17	Professional		$103.14	$180.14	$216.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $90.87 / $180.01 / $947.19	Facility		$90.87	$180.01	$947.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $104.85 / $196.15	Professional		$81.59	$104.85	$196.15
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 $58.02 / $136.31 / $207.16	Facility		$58.02	$136.31	$207.16
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $103.14 / $180.14 / $216.17	Professional		$103.14	$180.14	$216.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $180.14 / $277.23 / $538.99	Professional		$180.14	$277.23	$538.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $116.53 / $351.84 / $947.19	Facility		$116.53	$351.84	$947.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $116.53 / $1,138.23	Professional		$85.07	$116.53	$1,138.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $180.14 / $180.14 / $180.14	Professional		$180.14	$180.14	$180.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $143.85 / $180.14 / $180.14	Professional		$143.85	$180.14	$180.14
United Facility/Professional Facility Modifier Low / Median / High Price $91.72 / $91.72 / $91.72	Facility		$91.72	$91.72	$91.72
United Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $89.87 / $172.26	Professional		$71.77	$89.87	$172.26