Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.43 / $115.43 / $115.43	Facility		$115.43	$115.43	$115.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.57 / $115.43 / $164.41	Professional		$86.57	$115.43	$164.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $228.81 / $251.69 / $416.43	Facility		$228.81	$251.69	$416.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.89 / $212.79 / $281.43	Professional		$197.89	$212.79	$281.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $164.61 / $489.65 / $489.65	Facility		$164.61	$489.65	$489.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $472.79 / $954.50	Facility		$111.95	$472.79	$954.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $331.41 / $433.05	Professional		$81.72	$331.41	$433.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.70 / $173.15 / $263.13	Facility		$57.70	$173.15	$263.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $131.01 / $228.81 / $274.57	Professional		$131.01	$228.81	$274.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.88 / $228.81 / $949.34	Facility		$99.88	$228.81	$949.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.38 / $114.16 / $249.15	Professional		$89.38	$114.16	$249.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $105.43	Professional		$50.00	$65.00	$105.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.70 / $173.15 / $263.13	Facility		$57.70	$173.15	$263.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $131.01 / $228.81 / $274.57	Professional		$131.01	$228.81	$274.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $228.81 / $343.22 / $535.98	Professional		$228.81	$343.22	$535.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $446.90 / $949.34	Facility		$111.95	$446.90	$949.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $111.95 / $1,146.61	Professional		$81.72	$111.95	$1,146.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $228.81 / $228.81 / $228.81	Professional		$228.81	$228.81	$228.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $228.81 / $228.81 / $228.81	Professional		$228.81	$228.81	$228.81
United Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $114.16 / $202.87	Professional		$76.09	$114.16	$202.87