Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.93 / $88.93 / $88.93	Facility		$88.93	$88.93	$88.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.72 / $88.93 / $159.00	Professional		$83.72	$88.93	$159.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $176.29 / $193.92 / $320.85	Facility		$176.29	$193.92	$320.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.47 / $163.95 / $216.83	Professional		$152.47	$163.95	$216.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.83 / $377.26 / $377.26	Facility		$126.83	$377.26	$377.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.16 / $364.91 / $736.17	Facility		$110.16	$364.91	$736.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.42 / $255.47 / $333.65	Professional		$80.42	$255.47	$333.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.78 / $133.40 / $202.73	Facility		$56.78	$133.40	$202.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $100.94 / $176.29 / $213.27	Professional		$100.94	$176.29	$213.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.93 / $175.39 / $918.20	Facility		$88.93	$175.39	$918.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $102.61 / $199.03	Professional		$79.86	$102.61	$199.03
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 $56.78 / $133.40 / $202.73	Facility		$56.78	$133.40	$202.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $100.94 / $176.29 / $213.27	Professional		$100.94	$176.29	$213.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $176.29 / $271.31 / $527.95	Professional		$176.29	$271.31	$527.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $110.16 / $344.32 / $918.20	Facility		$110.16	$344.32	$918.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.42 / $110.16 / $1,170.59	Professional		$80.42	$110.16	$1,170.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $176.29 / $176.29 / $176.29	Professional		$176.29	$176.29	$176.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $176.29 / $176.29 / $176.29	Professional		$176.29	$176.29	$176.29
United Facility/Professional Professional Modifier Low / Median / High Price $70.23 / $97.64 / $164.76	Professional		$70.23	$97.64	$164.76