Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.13 / $87.13 / $87.13	Facility		$87.13	$87.13	$87.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.46 / $87.13 / $156.61	Professional		$82.46	$87.13	$156.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.72 / $189.99 / $314.35	Facility		$172.72	$189.99	$314.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.38 / $160.63 / $212.44	Professional		$149.38	$160.63	$212.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $124.25 / $369.62 / $369.62	Facility		$124.25	$369.62	$369.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.46 / $357.40 / $720.78	Facility		$116.46	$357.40	$720.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.02 / $250.31 / $326.89	Professional		$85.02	$250.31	$326.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $49.69 / $130.69 / $198.63	Facility		$49.69	$130.69	$198.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $98.90 / $168.56 / $207.26	Professional		$98.90	$168.56	$207.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.02 / $172.72 / $804.26	Facility		$86.02	$172.72	$804.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.41 / $90.47 / $188.07	Professional		$75.41	$90.47	$188.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $95.62	Professional		$50.00	$65.00	$95.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $49.69 / $130.69 / $198.63	Facility		$49.69	$130.69	$198.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $98.90 / $168.56 / $207.26	Professional		$98.90	$168.56	$207.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $172.72 / $265.82 / $461.70	Professional		$172.72	$265.82	$461.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $116.46 / $337.34 / $804.26	Facility		$116.46	$337.34	$804.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.02 / $116.46 / $869.66	Professional		$85.02	$116.46	$869.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $172.72 / $172.72 / $172.72	Professional		$172.72	$172.72	$172.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $137.91 / $172.72 / $172.72	Professional		$137.91	$172.72	$172.72
United Facility/Professional Professional Modifier Low / Median / High Price $64.15 / $86.17 / $172.72	Professional		$64.15	$86.17	$172.72