Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.06 / $143.06 / $143.06	Facility		$143.06	$143.06	$143.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $143.06 / $197.04	Professional		$101.00	$143.06	$197.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $283.58 / $311.94 / $516.12	Facility		$283.58	$311.94	$516.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.26 / $263.73 / $348.80	Professional		$245.26	$263.73	$348.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $204.00 / $606.86 / $606.86	Facility		$204.00	$606.86	$606.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.11 / $586.30 / $1,184.03	Facility		$150.11	$586.30	$1,184.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.58 / $411.09 / $536.69	Professional		$109.58	$411.09	$536.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $68.50 / $214.59 / $326.12	Facility		$68.50	$214.59	$326.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $212.68 / $340.30	Professional		$162.38	$212.68	$340.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $118.58 / $283.58 / $1,107.57	Facility		$118.58	$283.58	$1,107.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.16 / $141.47 / $308.79	Professional		$105.16	$141.47	$308.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $68.50 / $214.59 / $326.12	Facility		$68.50	$214.59	$326.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $212.68 / $340.30	Professional		$162.38	$212.68	$340.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $283.58 / $425.37 / $636.35	Professional		$283.58	$425.37	$636.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $150.11 / $553.86 / $1,107.57	Facility		$150.11	$553.86	$1,107.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.58 / $150.11 / $1,403.72	Professional		$109.58	$150.11	$1,403.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $283.58 / $283.58 / $283.58	Professional		$283.58	$283.58	$283.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $226.43 / $283.58 / $283.58	Professional		$226.43	$283.58	$283.58
United Facility/Professional Professional Modifier Low / Median / High Price $94.32 / $141.47 / $265.26	Professional		$94.32	$141.47	$265.26