Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.74 / $98.74 / $98.74	Facility		$98.74	$98.74	$98.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.73 / $98.74 / $168.96	Professional		$83.73	$98.74	$168.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $195.73 / $215.30 / $356.23	Facility		$195.73	$215.30	$356.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.15 / $182.03 / $240.74	Professional		$176.15	$182.03	$240.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.81 / $418.86 / $418.86	Facility		$140.81	$418.86	$418.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $122.31 / $404.32 / $817.35	Facility		$122.31	$404.32	$817.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.29 / $283.58 / $370.45	Professional		$89.29	$283.58	$370.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.04 / $148.11 / $225.09	Facility		$63.04	$148.11	$225.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $112.07 / $195.73 / $260.98	Professional		$112.07	$195.73	$260.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.74 / $195.73 / $1,037.98	Facility		$98.74	$195.73	$1,037.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.01 / $130.79 / $220.98	Professional		$91.01	$130.79	$220.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $132.10	Professional		$50.00	$70.00	$132.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $63.04 / $148.41 / $225.09	Facility		$63.04	$148.41	$225.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $112.07 / $195.73 / $260.98	Professional		$112.07	$195.73	$260.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $195.73 / $301.23 / $586.16	Professional		$195.73	$301.23	$586.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $122.31 / $382.30 / $1,037.98	Facility		$122.31	$382.30	$1,037.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.29 / $122.31 / $1,291.84	Professional		$89.29	$122.31	$1,291.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $195.73 / $195.73 / $195.73	Professional		$195.73	$195.73	$195.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $195.73 / $195.73 / $195.73	Professional		$195.73	$195.73	$195.73
United Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $117.44 / $173.54	Professional		$77.98	$117.44	$173.54