Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.90 / $108.90 / $108.90	Facility		$108.90	$108.90	$108.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.72 / $108.90 / $189.38	Professional		$99.72	$108.90	$189.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $215.88 / $237.47 / $392.90	Facility		$215.88	$237.47	$392.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.29 / $200.77 / $265.52	Professional		$194.29	$200.77	$265.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $155.30 / $461.98 / $461.98	Facility		$155.30	$461.98	$461.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.66 / $446.53 / $901.32	Facility		$139.66	$446.53	$901.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.95 / $312.66 / $408.58	Professional		$101.95	$312.66	$408.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $67.63 / $163.35 / $248.26	Facility		$67.63	$163.35	$248.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $123.61 / $215.88 / $279.95	Professional		$123.61	$215.88	$279.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.90 / $215.88 / $1,100.50	Facility		$108.90	$215.88	$1,100.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.85 / $122.21 / $243.73	Professional		$96.85	$122.21	$243.73
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 $67.63 / $163.35 / $248.26	Facility		$67.63	$163.35	$248.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $123.61 / $215.88 / $279.95	Professional		$123.61	$215.88	$279.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $215.88 / $332.25 / $628.32	Professional		$215.88	$332.25	$628.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $139.66 / $421.64 / $1,100.50	Facility		$139.66	$421.64	$1,100.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.95 / $139.66 / $1,394.20	Professional		$101.95	$139.66	$1,394.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.88 / $215.88 / $215.88	Professional		$215.88	$215.88	$215.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.88 / $215.88 / $215.88	Professional		$215.88	$215.88	$215.88
United Facility/Professional Professional Modifier Low / Median / High Price $86.01 / $107.70 / $196.23	Professional		$86.01	$107.70	$196.23