Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.47 / $106.47 / $106.47	Facility		$106.47	$106.47	$106.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.99 / $106.47 / $199.39	Professional		$104.99	$106.47	$199.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $211.05 / $232.16 / $384.11	Facility		$211.05	$232.16	$384.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.28 / $196.28 / $259.58	Professional		$196.28	$196.28	$259.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.82 / $451.65 / $451.65	Facility		$151.82	$451.65	$451.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.01 / $436.22 / $880.33	Facility		$144.01	$436.22	$880.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.13 / $305.63 / $399.43	Professional		$105.13	$305.63	$399.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $55.85 / $159.71 / $242.71	Facility		$55.85	$159.71	$242.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $120.83 / $211.05 / $253.26	Professional		$120.83	$211.05	$253.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.68 / $211.05 / $928.70	Facility		$96.68	$211.05	$928.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.08 / $105.29 / $229.81	Professional		$84.08	$105.29	$229.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $99.85	Professional		$50.00	$65.00	$99.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $55.85 / $159.71 / $242.71	Facility		$55.85	$159.71	$242.71
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $120.83 / $211.05 / $253.26	Professional		$120.83	$211.05	$253.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $211.05 / $324.77 / $518.91	Professional		$211.05	$324.77	$518.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $144.01 / $412.20 / $928.70	Facility		$144.01	$412.20	$928.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.13 / $144.01 / $1,217.75	Professional		$105.13	$144.01	$1,217.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $211.05 / $211.05 / $211.05	Professional		$211.05	$211.05	$211.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $211.05 / $211.05 / $211.05	Professional		$211.05	$211.05	$211.05
United Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $105.29 / $211.05	Professional		$72.09	$105.29	$211.05