Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.92 / $113.92 / $113.92	Facility		$113.92	$113.92	$113.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.25 / $113.92 / $203.68	Professional		$107.25	$113.92	$203.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $225.84 / $248.42 / $411.03	Facility		$225.84	$248.42	$411.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.32 / $210.03 / $277.77	Professional		$195.32	$210.03	$277.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.47 / $483.30 / $483.30	Facility		$162.47	$483.30	$483.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.12 / $467.16 / $943.31	Facility		$141.12	$467.16	$943.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $376.12 / $427.41	Professional		$103.02	$376.12	$427.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.73 / $170.88 / $259.72	Facility		$72.73	$170.88	$259.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $225.84 / $301.11	Professional		$129.31	$225.84	$301.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $113.92 / $224.67 / $1,262.20	Facility		$113.92	$224.67	$1,262.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.30 / $131.44 / $254.97	Professional		$102.30	$131.44	$254.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $91.58	Professional		$50.00	$65.00	$91.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $72.73 / $170.88 / $259.72	Facility		$72.73	$170.88	$259.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $225.84 / $301.11	Professional		$129.31	$225.84	$301.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $225.84 / $347.54 / $676.49	Professional		$225.84	$347.54	$676.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $141.12 / $441.08 / $1,262.20	Facility		$141.12	$441.08	$1,262.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $141.12 / $3,381.35	Professional		$103.02	$141.12	$3,381.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $225.84 / $225.84 / $225.84	Professional		$225.84	$225.84	$225.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $180.33 / $225.84 / $225.84	Professional		$180.33	$225.84	$225.84
United Facility/Professional Facility Modifier Low / Median / High Price $150.50 / $150.50 / $150.50	Facility		$150.50	$150.50	$150.50
United Facility/Professional Professional Modifier Low / Median / High Price $89.97 / $112.85 / $215.95	Professional		$89.97	$112.85	$215.95