Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $349.78 / $379.94	Facility		$95.50	$349.78	$379.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.34 / $95.50 / $136.91	Professional		$77.34	$95.50	$136.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $189.31 / $208.24 / $344.54	Facility		$189.31	$208.24	$344.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.37 / $176.06 / $232.85	Professional		$170.37	$176.06	$232.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $405.12 / $405.12	Facility		$136.19	$405.12	$405.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.36 / $391.18 / $790.75	Facility		$117.36	$391.18	$790.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.67 / $274.22 / $358.28	Professional		$85.67	$274.22	$358.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $48.61 / $142.30 / $217.71	Facility		$48.61	$142.30	$217.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $108.40 / $187.16 / $227.17	Professional		$108.40	$187.16	$227.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.15 / $189.31 / $791.34	Facility		$84.15	$189.31	$791.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.63 / $94.45 / $206.14	Professional		$74.63	$94.45	$206.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $48.61 / $143.25 / $217.71	Facility		$48.61	$143.25	$217.71
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $108.40 / $187.16 / $227.17	Professional		$108.40	$187.16	$227.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $288.14 / $451.67	Professional		$189.31	$288.14	$451.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $117.36 / $369.74 / $791.34	Facility		$117.36	$369.74	$791.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.67 / $117.36 / $898.37	Professional		$85.67	$117.36	$898.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $189.31 / $189.31	Professional		$189.31	$189.31	$189.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $189.31 / $189.31	Professional		$151.16	$189.31	$189.31
United Facility/Professional Professional Modifier Low / Median / High Price $62.97 / $94.45 / $189.31	Professional		$62.97	$94.45	$189.31