Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.03 / $116.03 / $116.03	Facility		$116.03	$116.03	$116.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.25 / $116.03 / $184.69	Professional		$97.25	$116.03	$184.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $230.00 / $253.00 / $418.60	Facility		$230.00	$253.00	$418.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.92 / $213.90 / $282.89	Professional		$198.92	$213.90	$282.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $165.47 / $492.20 / $492.20	Facility		$165.47	$492.20	$492.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.51 / $507.91 / $960.10	Facility		$116.51	$507.91	$960.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $338.61 / $435.30	Professional		$85.05	$338.61	$435.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.05 / $174.05 / $264.50	Facility		$60.05	$174.05	$264.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $131.69 / $230.00 / $276.00	Professional		$131.69	$230.00	$276.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.95 / $230.00 / $992.11	Facility		$103.95	$230.00	$992.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.63 / $114.75 / $250.44	Professional		$91.63	$114.75	$250.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $121.03	Professional		$50.00	$70.00	$121.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.05 / $174.05 / $264.50	Facility		$60.05	$174.05	$264.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $131.69 / $230.00 / $276.00	Professional		$131.69	$230.00	$276.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $230.00 / $353.98 / $558.05	Professional		$230.00	$353.98	$558.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $116.51 / $449.22 / $992.11	Facility		$116.51	$449.22	$992.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $116.51 / $1,193.23	Professional		$85.05	$116.51	$1,193.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $230.00 / $230.00 / $230.00	Professional		$230.00	$230.00	$230.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $230.00 / $230.00 / $230.00	Professional		$230.00	$230.00	$230.00
United Facility/Professional Facility Modifier Low / Median / High Price $0.15 / $92.18 / $108.52	Facility		$0.15	$92.18	$108.52
United Facility/Professional Professional Modifier Low / Median / High Price $77.52 / $114.75 / $203.92	Professional		$77.52	$114.75	$203.92