Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.19 / $79.19 / $79.19	Facility		$79.19	$79.19	$79.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $79.19 / $142.36	Professional		$74.95	$79.19	$142.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $156.97 / $172.67 / $285.69	Facility		$156.97	$172.67	$285.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.76 / $145.97 / $193.07	Professional		$135.76	$145.97	$193.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.93 / $335.92 / $335.92	Facility		$112.93	$335.92	$335.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.06 / $346.63 / $655.00	Facility		$99.06	$346.63	$655.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $227.34 / $297.08	Professional		$72.31	$227.34	$297.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.17 / $118.79 / $180.52	Facility		$45.17	$118.79	$180.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.87 / $153.19 / $188.36	Professional		$89.87	$153.19	$188.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.19 / $156.97 / $730.97	Facility		$78.19	$156.97	$730.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $82.23 / $170.93	Professional		$68.56	$82.23	$170.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $105.93	Professional		$50.00	$65.00	$105.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.17 / $118.79 / $180.52	Facility		$45.17	$118.79	$180.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $89.87 / $153.19 / $188.36	Professional		$89.87	$153.19	$188.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $156.97 / $241.58 / $419.55	Professional		$156.97	$241.58	$419.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $99.06 / $306.58 / $730.97	Facility		$99.06	$306.58	$730.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $99.06 / $790.38	Professional		$72.31	$99.06	$790.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $156.97 / $156.97 / $156.97	Professional		$156.97	$156.97	$156.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $156.97 / $156.97 / $156.97	Professional		$156.97	$156.97	$156.97
United Facility/Professional Professional Modifier Low / Median / High Price $58.30 / $78.31 / $151.97	Professional		$58.30	$78.31	$151.97