Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.63 / $93.63 / $93.63	Facility		$93.63	$93.63	$93.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.63 / $94.27 / $185.97	Professional		$93.63	$94.27	$185.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.60 / $204.16 / $337.79	Facility		$185.60	$204.16	$337.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.04 / $172.61 / $228.28	Professional		$167.04	$172.61	$228.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $133.52 / $397.18 / $397.18	Facility		$133.52	$397.18	$397.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.06 / $383.68 / $775.36	Facility		$120.06	$383.68	$775.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.64 / $269.06 / $351.26	Professional		$87.64	$269.06	$351.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $54.63 / $140.44 / $213.44	Facility		$54.63	$140.44	$213.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $106.26 / $169.61 / $222.72	Professional		$106.26	$169.61	$222.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.63 / $185.60 / $878.76	Facility		$93.63	$185.60	$878.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.16 / $98.72 / $202.10	Professional		$81.16	$98.72	$202.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $100.86	Professional		$50.00	$65.00	$100.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $54.63 / $140.44 / $213.44	Facility		$54.63	$140.44	$213.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $106.26 / $169.61 / $222.72	Professional		$106.26	$169.61	$222.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $185.60 / $285.62 / $507.87	Professional		$185.60	$285.62	$507.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $120.06 / $362.50 / $878.76	Facility		$120.06	$362.50	$878.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.64 / $120.06 / $1,011.39	Professional		$87.64	$120.06	$1,011.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $185.60 / $185.60 / $185.60	Professional		$185.60	$185.60	$185.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $185.60 / $185.60 / $185.60	Professional		$185.60	$185.60	$185.60
United Facility/Professional Professional Modifier Low / Median / High Price $70.52 / $92.59 / $177.47	Professional		$70.52	$92.59	$177.47