Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.84 / $656.63 / $713.02	Facility		$109.84	$656.63	$713.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.56 / $115.79 / $151.29	Professional		$91.56	$115.79	$151.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $217.73 / $239.50 / $396.27	Facility		$217.73	$239.50	$396.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.95 / $202.49 / $267.80	Professional		$195.95	$202.49	$267.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $156.63 / $465.94 / $465.94	Facility		$156.63	$465.94	$465.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.33 / $450.26 / $908.32	Facility		$138.33	$450.26	$908.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $362.63 / $412.08	Professional		$100.98	$362.63	$412.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $164.76 / $250.39	Facility		$62.10	$164.76	$250.39
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $124.66 / $192.80 / $261.27	Professional		$124.66	$192.80	$261.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.49 / $217.73 / $969.09	Facility		$107.49	$217.73	$969.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $114.06 / $237.08	Professional		$88.93	$114.06	$237.08
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 $62.10 / $164.76 / $250.39	Facility		$62.10	$164.76	$250.39
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $124.66 / $192.80 / $261.27	Professional		$124.66	$192.80	$261.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $217.73 / $335.10 / $577.13	Professional		$217.73	$335.10	$577.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $138.33 / $425.26 / $969.09	Facility		$138.33	$425.26	$969.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $203.46 / $1,272.50	Professional		$100.98	$203.46	$1,272.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $217.73 / $217.73 / $217.73	Professional		$217.73	$217.73	$217.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $217.73 / $217.73 / $217.73	Professional		$217.73	$217.73	$217.73
United Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $108.62 / $205.66	Professional		$75.31	$108.62	$205.66