Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.30 / $105.30 / $105.30	Facility		$105.30	$105.30	$105.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.66 / $105.30 / $189.27	Professional		$99.66	$105.30	$189.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.74 / $229.61 / $379.91	Facility		$208.74	$229.61	$379.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.86 / $194.13 / $256.75	Professional		$187.86	$194.13	$256.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $150.16 / $446.70 / $446.70	Facility		$150.16	$446.70	$446.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.05 / $431.52 / $871.93	Facility		$147.05	$431.52	$871.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.35 / $347.66 / $395.06	Professional		$107.35	$347.66	$395.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.43 / $157.94 / $240.05	Facility		$60.43	$157.94	$240.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $119.51 / $203.70 / $250.49	Professional		$119.51	$203.70	$250.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.61 / $208.74 / $981.02	Facility		$104.61	$208.74	$981.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.14 / $109.34 / $227.29	Professional		$91.14	$109.34	$227.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $134.56	Professional		$50.00	$70.00	$134.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.43 / $157.94 / $240.05	Facility		$60.43	$157.94	$240.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $119.51 / $203.70 / $250.49	Professional		$119.51	$203.70	$250.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.74 / $321.22 / $562.07	Professional		$208.74	$321.22	$562.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $147.05 / $407.70 / $981.02	Facility		$147.05	$407.70	$981.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.35 / $147.05 / $1,050.93	Professional		$107.35	$147.05	$1,050.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $208.74 / $208.74 / $208.74	Professional		$208.74	$208.74	$208.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $208.74 / $208.74 / $208.74	Professional		$208.74	$208.74	$208.74
United Facility/Professional Professional Modifier Low / Median / High Price $83.16 / $104.14 / $185.07	Professional		$83.16	$104.14	$185.07