Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.34 / $94.34 / $94.34	Facility		$94.34	$94.34	$94.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.84 / $94.34 / $182.20	Professional		$84.84	$94.34	$182.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $187.01 / $205.71 / $340.36	Facility		$187.01	$205.71	$340.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.92 / $173.92 / $230.02	Professional		$173.92	$173.92	$230.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.53 / $400.20 / $400.20	Facility		$134.53	$400.20	$400.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.63 / $386.47 / $780.96	Facility		$132.63	$386.47	$780.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.83 / $270.94 / $353.94	Professional		$96.83	$270.94	$353.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $48.80 / $140.57 / $215.06	Facility		$48.80	$140.57	$215.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $107.06 / $167.01 / $224.41	Professional		$107.06	$167.01	$224.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.47 / $187.01 / $797.99	Facility		$84.47	$187.01	$797.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.50 / $93.29 / $203.63	Professional		$74.50	$93.29	$203.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $89.64	Professional		$50.00	$65.00	$89.64
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $48.80 / $141.51 / $215.06	Facility		$48.80	$141.51	$215.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $107.06 / $167.01 / $224.41	Professional		$107.06	$167.01	$224.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $187.01 / $287.79 / $453.67	Professional		$187.01	$287.79	$453.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $132.63 / $365.26 / $797.99	Facility		$132.63	$365.26	$797.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.83 / $132.63 / $821.86	Professional		$96.83	$132.63	$821.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $187.01 / $187.01 / $187.01	Professional		$187.01	$187.01	$187.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $149.30 / $187.01 / $187.01	Professional		$149.30	$187.01	$187.01
United Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $93.29 / $165.81	Professional		$62.99	$93.29	$165.81