Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $81.70 / $81.70	Facility		$81.70	$81.70	$81.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.01 / $81.70 / $119.67	Professional		$63.01	$81.70	$119.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $161.97 / $178.17 / $294.79	Facility		$161.97	$178.17	$294.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.77 / $150.63 / $199.22	Professional		$145.77	$150.63	$199.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $116.51 / $346.62 / $346.62	Facility		$116.51	$346.62	$346.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $334.90 / $675.99	Facility		$106.22	$334.90	$675.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.54 / $234.84 / $306.54	Professional		$77.54	$234.84	$306.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.73 / $122.55 / $186.27	Facility		$42.73	$122.55	$186.27
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $92.72 / $161.97 / $194.36	Professional		$92.72	$161.97	$194.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.97 / $161.97 / $729.99	Facility		$73.97	$161.97	$729.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.53 / $80.80 / $176.36	Professional		$64.53	$80.80	$176.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $42.73 / $122.55 / $186.27	Facility		$42.73	$122.55	$186.27
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $92.72 / $161.97 / $194.36	Professional		$92.72	$161.97	$194.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $161.97 / $249.25 / $397.47	Professional		$161.97	$249.25	$397.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $316.33 / $729.99	Facility		$106.22	$316.33	$729.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.54 / $106.22 / $1,419.30	Professional		$77.54	$106.22	$1,419.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $161.97 / $161.97 / $161.97	Professional		$161.97	$161.97	$161.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $161.97 / $161.97	Professional		$129.31	$161.97	$161.97
United Facility/Professional Facility Modifier Low / Median / High Price $0.11 / $65.59 / $75.06	Facility		$0.11	$65.59	$75.06
United Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $80.80 / $143.60	Professional		$53.87	$80.80	$143.60