Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.40 / $80.40 / $80.40	Facility		$80.40	$80.40	$80.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.08 / $81.90 / $131.32	Professional		$76.08	$81.90	$131.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.37 / $175.31 / $290.05	Facility		$159.37	$175.31	$290.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.83 / $148.21 / $196.02	Professional		$137.83	$148.21	$196.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.65 / $341.05 / $341.05	Facility		$114.65	$341.05	$341.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.96 / $351.65 / $664.79	Facility		$88.96	$351.65	$664.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.94 / $231.09 / $301.61	Professional		$64.94	$231.09	$301.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.85 / $120.60 / $183.28	Facility		$45.85	$120.60	$183.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $91.26 / $155.55 / $191.24	Professional		$91.26	$155.55	$191.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.37 / $159.37 / $742.11	Facility		$79.37	$159.37	$742.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.58 / $83.48 / $173.53	Professional		$69.58	$83.48	$173.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.35 / $58.40 / $85.00	Professional		$4.35	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.85 / $120.60 / $183.28	Facility		$45.85	$120.60	$183.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $91.26 / $155.55 / $191.24	Professional		$91.26	$155.55	$191.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $159.37 / $245.27 / $426.57	Professional		$159.37	$245.27	$426.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.96 / $311.26 / $742.11	Facility		$88.96	$311.26	$742.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.94 / $88.96 / $802.33	Professional		$64.94	$88.96	$802.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $159.37 / $159.37 / $159.37	Professional		$159.37	$159.37	$159.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.25 / $159.37 / $159.37	Professional		$127.25	$159.37	$159.37
United Facility/Professional Professional Modifier Low / Median / High Price $55.61 / $79.51 / $152.38	Professional		$55.61	$79.51	$152.38