Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.09 / $97.09 / $97.09	Facility		$97.09	$97.09	$97.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.88 / $97.09 / $174.49	Professional		$91.88	$97.09	$174.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $192.46 / $211.71 / $350.28	Facility		$192.46	$211.71	$350.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.21 / $178.99 / $236.72	Professional		$173.21	$178.99	$236.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.46 / $411.86 / $411.86	Facility		$138.46	$411.86	$411.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.42 / $397.74 / $803.35	Facility		$107.42	$397.74	$803.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.42 / $278.91 / $364.25	Professional		$78.42	$278.91	$364.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $55.36 / $144.66 / $221.33	Facility		$55.36	$144.66	$221.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $110.18 / $187.82 / $230.95	Professional		$110.18	$187.82	$230.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.84 / $192.46 / $899.40	Facility		$95.84	$192.46	$899.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.03 / $102.02 / $209.57	Professional		$84.03	$102.02	$209.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.58 / $109.30	Professional		$50.00	$65.58	$109.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $55.36 / $145.63 / $221.33	Facility		$55.36	$145.63	$221.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $110.18 / $187.82 / $230.95	Professional		$110.18	$187.82	$230.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $192.46 / $296.18 / $514.90	Professional		$192.46	$296.18	$514.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $107.42 / $375.90 / $899.40	Facility		$107.42	$375.90	$899.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.42 / $107.42 / $968.61	Professional		$78.42	$107.42	$968.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $192.46 / $192.46 / $192.46	Professional		$192.46	$192.46	$192.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $153.66 / $192.46 / $192.46	Professional		$153.66	$192.46	$192.46
United Facility/Professional Facility Modifier Low / Median / High Price $0.14 / $85.00 / $100.06	Facility		$0.14	$85.00	$100.06
United Facility/Professional Professional Modifier Low / Median / High Price $67.15 / $96.02 / $192.46	Professional		$67.15	$96.02	$192.46