Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Facility		$89.31	$89.31	$89.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.66 / $89.31 / $134.77	Professional		$71.66	$89.31	$134.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.04 / $194.74 / $322.20	Facility		$177.04	$194.74	$322.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.33 / $164.65 / $217.75	Professional		$159.33	$164.65	$217.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.37 / $378.87 / $378.87	Facility		$127.37	$378.87	$378.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.79 / $365.86 / $738.97	Facility		$97.79	$365.86	$738.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.39 / $256.41 / $335.06	Professional		$71.39	$256.41	$335.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $48.60 / $133.97 / $203.60	Facility		$48.60	$133.97	$203.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $101.37 / $177.04 / $212.45	Professional		$101.37	$177.04	$212.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.13 / $177.04 / $804.59	Facility		$84.13	$177.04	$804.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.54 / $89.55 / $192.78	Professional		$70.54	$89.55	$192.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $102.57	Professional		$50.00	$65.00	$102.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $48.60 / $133.97 / $203.60	Facility		$48.60	$133.97	$203.60
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $101.37 / $177.04 / $212.45	Professional		$101.37	$177.04	$212.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.04 / $272.47 / $451.67	Professional		$177.04	$272.47	$451.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $97.79 / $345.78 / $804.59	Facility		$97.79	$345.78	$804.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.39 / $97.79 / $1,001.98	Professional		$71.39	$97.79	$1,001.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $177.04 / $177.04 / $177.04	Professional		$177.04	$177.04	$177.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $141.36 / $177.04 / $177.04	Professional		$141.36	$177.04	$177.04
United Facility/Professional Facility Modifier Low / Median / High Price $0.12 / $74.61 / $87.83	Facility		$0.12	$74.61	$87.83
United Facility/Professional Professional Modifier Low / Median / High Price $62.74 / $88.33 / $169.29	Professional		$62.74	$88.33	$169.29