Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.94 / $96.94 / $96.94	Facility		$96.94	$96.94	$96.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.26 / $96.94 / $173.32	Professional		$91.26	$96.94	$173.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $192.17 / $211.39 / $349.75	Facility		$192.17	$211.39	$349.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.95 / $178.72 / $236.36	Professional		$172.95	$178.72	$236.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.25 / $411.24 / $411.24	Facility		$138.25	$411.24	$411.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.31 / $397.74 / $801.95	Facility		$124.31	$397.74	$801.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.75 / $320.06 / $363.70	Professional		$90.75	$320.06	$363.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $61.89 / $145.41 / $221.00	Facility		$61.89	$145.41	$221.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $110.03 / $192.17 / $230.60	Professional		$110.03	$192.17	$230.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.94 / $191.19 / $1,000.92	Facility		$96.94	$191.19	$1,000.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.05 / $111.85 / $216.97	Professional		$87.05	$111.85	$216.97
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 $61.89 / $145.41 / $221.00	Facility		$61.89	$145.41	$221.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $110.03 / $192.17 / $230.60	Professional		$110.03	$192.17	$230.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $192.17 / $295.73 / $575.12	Professional		$192.17	$295.73	$575.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $124.31 / $375.34 / $1,000.92	Facility		$124.31	$375.34	$1,000.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $90.75 / $124.31 / $1,276.03	Professional		$90.75	$124.31	$1,276.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $192.17 / $192.17 / $192.17	Professional		$192.17	$192.17	$192.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $192.17 / $192.17 / $192.17	Professional		$192.17	$192.17	$192.17
United Facility/Professional Professional Modifier Low / Median / High Price $76.56 / $110.81 / $179.59	Professional		$76.56	$110.81	$179.59