Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.40 / $97.40 / $97.40	Facility		$97.40	$97.40	$97.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.19 / $97.40 / $175.08	Professional		$92.19	$97.40	$175.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.08 / $212.39 / $351.41	Facility		$193.08	$212.39	$351.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.77 / $179.56 / $237.48	Professional		$173.77	$179.56	$237.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.90 / $413.19 / $413.19	Facility		$138.90	$413.19	$413.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.78 / $425.79 / $806.15	Facility		$107.78	$425.79	$806.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $279.83 / $365.41	Professional		$78.68	$279.83	$365.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $146.10 / $222.04	Facility		$55.55	$146.10	$222.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $110.54 / $188.45 / $231.70	Professional		$110.54	$188.45	$231.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.17 / $193.08 / $899.12	Facility		$96.17	$193.08	$899.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.31 / $101.14 / $210.23	Professional		$84.31	$101.14	$210.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.23 / $58.40 / $85.00	Professional		$43.23	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $146.10 / $222.04	Facility		$55.55	$146.10	$222.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $110.54 / $188.45 / $231.70	Professional		$110.54	$188.45	$231.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $193.08 / $297.14 / $515.90	Professional		$193.08	$297.14	$515.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $107.78 / $377.10 / $899.12	Facility		$107.78	$377.10	$899.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $107.78 / $972.15	Professional		$78.68	$107.78	$972.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $193.08 / $193.08 / $193.08	Professional		$193.08	$193.08	$193.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $154.16 / $193.08 / $193.08	Professional		$154.16	$193.08	$193.08
United Facility/Professional Facility Modifier Low / Median / High Price $0.14 / $85.28 / $100.39	Facility		$0.14	$85.28	$100.39
United Facility/Professional Professional Modifier Low / Median / High Price $71.70 / $96.32 / $184.62	Professional		$71.70	$96.32	$184.62