Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.22 / $79.22 / $79.22	Facility		$79.22	$79.22	$79.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.91 / $84.85 / $123.04	Professional		$69.91	$84.85	$123.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $157.05 / $172.76 / $285.83	Facility		$157.05	$172.76	$285.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.34 / $146.06 / $193.17	Professional		$141.34	$146.06	$193.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.99 / $176.66 / $336.09	Facility		$112.99	$176.66	$336.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $157.05 / $164.90 / $206.11	Professional		$157.05	$164.90	$206.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.60 / $324.58 / $655.00	Facility		$102.60	$324.58	$655.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $227.81 / $297.23	Professional		$74.90	$227.81	$297.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.51 / $118.83 / $180.61	Facility		$45.51	$118.83	$180.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $157.05 / $188.46	Professional		$89.93	$157.05	$188.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.78 / $157.05 / $744.59	Facility		$78.78	$157.05	$744.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.86 / $86.90 / $176.20	Professional		$69.86	$86.90	$176.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $91.62	Professional		$50.00	$65.00	$91.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.51 / $118.83 / $180.61	Facility		$45.51	$118.83	$180.61
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $157.05 / $188.46	Professional		$89.93	$157.05	$188.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $157.05 / $241.72 / $422.56	Professional		$157.05	$241.72	$422.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $102.60 / $306.74 / $744.59	Facility		$102.60	$306.74	$744.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $102.60 / $914.49	Professional		$74.90	$102.60	$914.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.05 / $157.05 / $157.05	Professional		$157.05	$157.05	$157.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $125.41 / $157.05 / $157.05	Professional		$125.41	$157.05	$157.05
United Facility/Professional Professional Modifier Low / Median / High Price $62.57 / $83.85 / $157.05	Professional		$62.57	$83.85	$157.05