Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.00 / $102.00 / $102.00	Facility		$102.00	$102.00	$102.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $108.29 / $183.39	Professional		$85.00	$108.29	$183.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.19 / $222.41 / $367.99	Facility		$202.19	$222.41	$367.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.04 / $188.04 / $248.69	Professional		$188.04	$188.04	$248.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $145.46 / $432.69 / $432.69	Facility		$145.46	$432.69	$432.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.67 / $418.40 / $843.94	Facility		$112.67	$418.40	$843.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $292.97 / $382.66	Professional		$82.25	$292.97	$382.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.07 / $151.97 / $232.52	Facility		$58.07	$151.97	$232.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $115.77 / $194.02 / $242.63	Professional		$115.77	$194.02	$242.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.53 / $202.19 / $939.42	Facility		$100.53	$202.19	$939.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.30 / $105.92 / $220.16	Professional		$88.30	$105.92	$220.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $115.65	Professional		$50.00	$65.00	$115.65
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $58.07 / $153.00 / $232.52	Facility		$58.07	$153.00	$232.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $115.77 / $194.02 / $242.63	Professional		$115.77	$194.02	$242.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $202.19 / $311.14 / $539.99	Professional		$202.19	$311.14	$539.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $112.67 / $394.90 / $939.42	Facility		$112.67	$394.90	$939.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $112.67 / $1,006.48	Professional		$82.25	$112.67	$1,006.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $202.19 / $202.19 / $202.19	Professional		$202.19	$202.19	$202.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $202.19 / $202.19 / $202.19	Professional		$202.19	$202.19	$202.19
United Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $100.87 / $193.34	Professional		$74.95	$100.87	$193.34