Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.58 / $80.58 / $80.58	Facility		$80.58	$80.58	$80.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.65 / $80.58 / $117.84	Professional		$62.65	$80.58	$117.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.72 / $175.70 / $290.70	Facility		$159.72	$175.70	$290.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.75 / $148.55 / $196.46	Professional		$143.75	$148.55	$196.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.91 / $341.82 / $341.82	Facility		$114.91	$341.82	$341.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.32 / $330.21 / $666.19	Facility		$103.32	$330.21	$666.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $231.56 / $302.31	Professional		$75.42	$231.56	$302.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.49 / $120.87 / $183.69	Facility		$42.49	$120.87	$183.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $91.46 / $159.72 / $191.68	Professional		$91.46	$159.72	$191.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.55 / $159.72 / $709.25	Facility		$73.55	$159.72	$709.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.64 / $79.69 / $173.93	Professional		$63.64	$79.69	$173.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $96.83	Professional		$50.00	$65.00	$96.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $42.49 / $120.87 / $183.69	Facility		$42.49	$120.87	$183.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $91.46 / $159.72 / $191.68	Professional		$91.46	$159.72	$191.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $239.60 / $394.45	Professional		$159.72	$239.60	$394.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $103.32 / $311.98 / $709.25	Facility		$103.32	$311.98	$709.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $103.32 / $888.80	Professional		$75.42	$103.32	$888.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $159.72 / $159.72	Professional		$159.72	$159.72	$159.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.54 / $159.72 / $159.72	Professional		$127.54	$159.72	$159.72
United Facility/Professional Professional Modifier Low / Median / High Price $53.12 / $79.69 / $152.72	Professional		$53.12	$79.69	$152.72