Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.79 / $74.79 / $74.79	Facility		$74.79	$74.79	$74.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.45 / $74.79 / $114.80	Professional		$60.45	$74.79	$114.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $148.25 / $163.08 / $269.82	Facility		$148.25	$163.08	$269.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.87 / $137.87 / $182.34	Professional		$137.87	$137.87	$182.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.66 / $317.26 / $317.26	Facility		$106.66	$317.26	$317.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.21 / $306.76 / $618.61	Facility		$104.21	$306.76	$618.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $246.92 / $280.58	Professional		$76.06	$246.92	$280.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.00 / $112.19 / $170.49	Facility		$41.00	$112.19	$170.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $84.88 / $148.25 / $177.90	Professional		$84.88	$148.25	$177.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.97 / $148.25 / $670.46	Facility		$70.97	$148.25	$670.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.06 / $75.54 / $161.43	Professional		$59.06	$75.54	$161.43
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 $41.00 / $112.19 / $170.49	Facility		$41.00	$112.19	$170.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $84.88 / $148.25 / $177.90	Professional		$84.88	$148.25	$177.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $148.25 / $228.13 / $381.41	Professional		$148.25	$228.13	$381.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $104.21 / $289.56 / $670.46	Facility		$104.21	$289.56	$670.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $104.21 / $840.16	Professional		$76.06	$104.21	$840.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $148.25 / $148.25 / $148.25	Professional		$148.25	$148.25	$148.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $148.25 / $148.25 / $148.25	Professional		$148.25	$148.25	$148.25
United Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $73.95 / $148.25	Professional		$52.92	$73.95	$148.25