Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.84 / $109.84 / $109.84	Facility		$109.84	$109.84	$109.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.71 / $109.84 / $183.03	Professional		$90.71	$109.84	$183.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $217.74 / $239.51 / $396.29	Facility		$217.74	$239.51	$396.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.96 / $202.50 / $267.82	Professional		$195.96	$202.50	$267.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $156.63 / $465.96 / $465.96	Facility		$156.63	$465.96	$465.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.85 / $450.26 / $908.32	Facility		$140.85	$450.26	$908.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.82 / $362.65 / $412.10	Professional		$102.82	$362.65	$412.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.13 / $164.76 / $250.40	Facility		$70.13	$164.76	$250.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $124.67 / $217.74 / $290.32	Professional		$124.67	$217.74	$290.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.84 / $217.74 / $1,167.33	Facility		$109.84	$217.74	$1,167.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.24 / $145.49 / $245.82	Professional		$101.24	$145.49	$245.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $103.34	Professional		$50.00	$65.00	$103.34
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $70.13 / $168.06 / $250.40	Facility		$70.13	$168.06	$250.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $124.67 / $217.74 / $290.32	Professional		$124.67	$217.74	$290.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $217.74 / $335.10 / $651.40	Professional		$217.74	$335.10	$651.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $140.85 / $425.28 / $1,167.33	Facility		$140.85	$425.28	$1,167.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.82 / $140.85 / $1,514.88	Professional		$102.82	$140.85	$1,514.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $217.74 / $217.74 / $217.74	Professional		$217.74	$217.74	$217.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $217.74 / $217.74 / $217.74	Professional		$217.74	$217.74	$217.74
United Facility/Professional Professional Modifier Low / Median / High Price $86.75 / $144.84 / $193.05	Professional		$86.75	$144.84	$193.05