Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.89 / $105.89 / $105.89	Facility		$105.89	$105.89	$105.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.23 / $105.89 / $190.36	Professional		$100.23	$105.89	$190.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $209.91 / $230.90 / $382.04	Facility		$209.91	$230.90	$382.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.55 / $195.22 / $258.18	Professional		$181.55	$195.22	$258.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.01 / $449.21 / $449.21	Facility		$151.01	$449.21	$449.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.11 / $463.86 / $876.13	Facility		$149.11	$463.86	$876.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.85 / $304.22 / $397.28	Professional		$108.85	$304.22	$397.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.40 / $158.84 / $241.40	Facility		$60.40	$158.84	$241.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $120.20 / $204.94 / $251.89	Professional		$120.20	$204.94	$251.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.56 / $209.91 / $977.65	Facility		$104.56	$209.91	$977.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.67 / $109.96 / $228.57	Professional		$91.67	$109.96	$228.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $189.81	Professional		$50.00	$70.00	$189.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.40 / $158.84 / $241.40	Facility		$60.40	$158.84	$241.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $120.20 / $204.94 / $251.89	Professional		$120.20	$204.94	$251.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $209.91 / $323.05 / $561.07	Professional		$209.91	$323.05	$561.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $149.11 / $409.98 / $977.65	Facility		$149.11	$409.98	$977.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.85 / $149.11 / $1,056.91	Professional		$108.85	$149.11	$1,056.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $209.91 / $209.91 / $209.91	Professional		$209.91	$209.91	$209.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $167.62 / $209.91 / $209.91	Professional		$167.62	$209.91	$209.91
United Facility/Professional Professional Modifier Low / Median / High Price $73.26 / $104.72 / $186.11	Professional		$73.26	$104.72	$186.11