Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.02 / $78.02 / $78.02	Facility		$78.02	$78.02	$78.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.76 / $78.02 / $130.68	Professional		$64.76	$78.02	$130.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.65 / $170.12 / $281.45	Facility		$154.65	$170.12	$281.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.75 / $143.82 / $190.21	Professional		$137.75	$143.82	$190.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.26 / $330.95 / $330.95	Facility		$111.26	$330.95	$330.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.03 / $341.63 / $645.20	Facility		$100.03	$341.63	$645.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $224.06 / $292.70	Professional		$73.02	$224.06	$292.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $44.49 / $117.03 / $177.85	Facility		$44.49	$117.03	$177.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $88.54 / $150.91 / $185.58	Professional		$88.54	$150.91	$185.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.01 / $154.65 / $720.06	Facility		$77.01	$154.65	$720.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.59 / $103.32 / $168.40	Professional		$70.59	$103.32	$168.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.85	Professional		$50.00	$65.00	$85.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $44.49 / $117.03 / $177.85	Facility		$44.49	$117.03	$177.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $88.54 / $150.91 / $185.58	Professional		$88.54	$150.91	$185.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.65 / $237.98 / $413.52	Professional		$154.65	$237.98	$413.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.03 / $302.06 / $720.06	Facility		$100.03	$302.06	$720.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $100.03 / $778.52	Professional		$73.02	$100.03	$778.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $154.65 / $154.65 / $154.65	Professional		$154.65	$154.65	$154.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.46 / $154.65 / $154.65	Professional		$123.46	$154.65	$154.65
United Facility/Professional Professional Modifier Low / Median / High Price $61.61 / $91.89 / $137.12	Professional		$61.61	$91.89	$137.12