Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.33 / $115.33 / $115.33	Facility		$115.33	$115.33	$115.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.62 / $115.33 / $185.66	Professional		$106.62	$115.33	$185.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $228.63 / $251.49 / $416.11	Facility		$228.63	$251.49	$416.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.76 / $212.63 / $281.20	Professional		$205.76	$212.63	$281.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $164.47 / $489.27 / $489.27	Facility		$164.47	$489.27	$489.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.61 / $504.91 / $954.50	Facility		$125.61	$504.91	$954.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.61 / $331.41 / $432.70	Professional		$125.61	$331.41	$432.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.75 / $173.00 / $262.92	Facility		$64.75	$173.00	$262.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $130.90 / $228.63 / $274.36	Professional		$130.90	$228.63	$274.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $115.10 / $228.63 / $1,045.23	Facility		$115.10	$228.63	$1,045.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $99.39 / $119.29 / $250.73	Professional		$99.39	$119.29	$250.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.15	Professional		$50.00	$65.00	$85.15
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.75 / $173.00 / $262.92	Facility		$64.75	$173.00	$262.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $130.90 / $228.63 / $274.36	Professional		$130.90	$228.63	$274.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $228.63 / $351.85 / $602.22	Professional		$228.63	$351.85	$602.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $125.61 / $446.54 / $1,045.23	Facility		$125.61	$446.54	$1,045.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.70 / $125.61 / $1,231.68	Professional		$91.70	$125.61	$1,231.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $228.63 / $228.63 / $228.63	Professional		$228.63	$228.63	$228.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $182.55 / $228.63 / $228.63	Professional		$182.55	$228.63	$228.63
United Facility/Professional Professional Modifier Low / Median / High Price $78.52 / $114.06 / $202.70	Professional		$78.52	$114.06	$202.70