Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.11 / $84.11 / $84.11	Facility		$84.11	$84.11	$84.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $84.11 / $121.93	Professional		$64.20	$84.11	$121.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $166.73 / $183.40 / $303.45	Facility		$166.73	$183.40	$303.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.05 / $155.06 / $205.07	Professional		$150.05	$155.06	$205.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $119.94 / $356.80 / $356.80	Facility		$119.94	$356.80	$356.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.36 / $344.29 / $695.58	Facility		$112.36	$344.29	$695.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.02 / $241.41 / $315.55	Professional		$82.02	$241.41	$315.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.54 / $126.17 / $191.74	Facility		$43.54	$126.17	$191.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $95.46 / $150.63 / $200.08	Professional		$95.46	$150.63	$200.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.38 / $166.73 / $701.53	Facility		$75.38	$166.73	$701.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.42 / $83.18 / $181.54	Professional		$66.42	$83.18	$181.54
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 $43.54 / $126.17 / $191.74	Facility		$43.54	$126.17	$191.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $95.46 / $150.63 / $200.08	Professional		$95.46	$150.63	$200.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $166.73 / $256.58 / $404.49	Professional		$166.73	$256.58	$404.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $112.36 / $325.64 / $701.53	Facility		$112.36	$325.64	$701.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.02 / $112.36 / $892.29	Professional		$82.02	$112.36	$892.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $166.73 / $166.73 / $166.73	Professional		$166.73	$166.73	$166.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $166.73 / $166.73 / $166.73	Professional		$166.73	$166.73	$166.73
United Facility/Professional Professional Modifier Low / Median / High Price $56.21 / $83.18 / $166.73	Professional		$56.21	$83.18	$166.73