Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.58 / $79.80 / $199.46	Facility		$72.58	$79.80	$199.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $106.85 / $173.22	Professional		$60.00	$106.85	$173.22
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 $177.67 / $177.67 / $234.97	Professional		$177.67	$177.67	$234.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $137.43 / $229.25 / $408.83	Facility		$137.43	$229.25	$408.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $191.04 / $200.59 / $268.87	Professional		$191.04	$200.59	$268.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.81 / $403.76 / $797.75	Facility		$120.81	$403.76	$797.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.19 / $277.02 / $361.55	Professional		$88.19	$277.02	$361.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $96.37 / $152.09 / $219.70	Facility		$96.37	$152.09	$219.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $186.43 / $191.04 / $229.25	Professional		$186.43	$191.04	$229.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.64 / $191.04 / $889.53	Facility		$103.64	$191.04	$889.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.82 / $106.86 / $213.52	Professional		$86.82	$106.86	$213.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $93.18	Professional		$50.00	$65.00	$93.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $96.37 / $152.83 / $219.70	Facility		$96.37	$152.83	$219.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $186.43 / $191.04 / $229.25	Professional		$186.43	$191.04	$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 $120.81 / $373.12 / $889.53	Facility		$120.81	$373.12	$889.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.19 / $120.81 / $961.74	Professional		$88.19	$120.81	$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 $191.04 / $191.04 / $191.04	Professional		$191.04	$191.04	$191.04
United Facility/Professional Professional Modifier Low / Median / High Price $66.79 / $99.32 / $182.67	Professional		$66.79	$99.32	$182.67