Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.40 / $128.40 / $128.40	Facility		$128.40	$128.40	$128.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.29 / $128.40 / $176.86	Professional		$92.29	$128.40	$176.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $254.53 / $279.98 / $463.24	Facility		$254.53	$279.98	$463.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.07 / $236.71 / $313.07	Professional		$229.07	$236.71	$313.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $183.11 / $544.69 / $544.69	Facility		$183.11	$544.69	$544.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.29 / $526.26 / $1,062.27	Facility		$119.29	$526.26	$1,062.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.08 / $423.92 / $481.73	Professional		$87.08	$423.92	$481.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $61.48 / $192.60 / $292.70	Facility		$61.48	$192.60	$292.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $145.74 / $207.68 / $305.44	Professional		$145.74	$207.68	$305.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $106.43 / $254.53 / $980.51	Facility		$106.43	$254.53	$980.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.24 / $126.98 / $277.16	Professional		$95.24	$126.98	$277.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $137.09	Professional		$50.00	$70.00	$137.09
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $61.48 / $192.60 / $292.70	Facility		$61.48	$192.60	$292.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $145.74 / $207.68 / $305.44	Professional		$145.74	$207.68	$305.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $254.53 / $381.80 / $571.11	Professional		$254.53	$381.80	$571.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $119.29 / $497.14 / $980.51	Facility		$119.29	$497.14	$980.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.08 / $119.29 / $1,118.57	Professional		$87.08	$119.29	$1,118.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $254.53 / $254.53 / $254.53	Professional		$254.53	$254.53	$254.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $254.53 / $254.53 / $254.53	Professional		$254.53	$254.53	$254.53
United Facility/Professional Professional Modifier Low / Median / High Price $84.66 / $126.98 / $246.44	Professional		$84.66	$126.98	$246.44