Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.55 / $180.00 / $311.25	Facility		$62.55	$180.00	$311.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.21 / $106.74 / $259.25	Professional		$91.21	$106.74	$259.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.04 / $210.14 / $347.69	Facility		$191.04	$210.14	$347.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.93 / $177.67 / $234.97	Professional		$171.93	$177.67	$234.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $137.43 / $408.83 / $408.83	Facility		$137.43	$408.83	$408.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.63 / $421.77 / $797.75	Facility		$106.63	$421.77	$797.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $277.02 / $361.55	Professional		$77.84	$277.02	$361.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $54.96 / $144.56 / $219.70	Facility		$54.96	$144.56	$219.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $109.38 / $186.43 / $229.25	Professional		$109.38	$186.43	$229.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.14 / $191.04 / $889.53	Facility		$95.14	$191.04	$889.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.42 / $101.27 / $208.01	Professional		$83.42	$101.27	$208.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $128.93	Professional		$50.00	$65.00	$128.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $54.96 / $144.56 / $219.70	Facility		$54.96	$144.56	$219.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $109.38 / $186.43 / $229.25	Professional		$109.38	$186.43	$229.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $191.04 / $293.99 / $510.88	Professional		$191.04	$293.99	$510.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $106.63 / $373.12 / $889.53	Facility		$106.63	$373.12	$889.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $106.63 / $961.74	Professional		$77.84	$106.63	$961.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $191.04 / $191.04 / $191.04	Professional		$191.04	$191.04	$191.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.54 / $191.04 / $191.04	Professional		$152.54	$191.04	$191.04
United Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $95.30 / $182.67	Professional		$70.95	$95.30	$182.67