Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.45 / $77.45 / $77.45	Facility		$77.45	$77.45	$77.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.96 / $77.45 / $129.06	Professional		$63.96	$77.45	$129.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $153.54 / $168.89 / $279.44	Facility		$153.54	$168.89	$279.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.18 / $142.79 / $188.85	Professional		$138.18	$142.79	$188.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $110.46 / $328.58 / $328.58	Facility		$110.46	$328.58	$328.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.32 / $317.08 / $641.00	Facility		$99.32	$317.08	$641.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $222.66 / $290.58	Professional		$72.50	$222.66	$290.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $49.45 / $116.18 / $176.57	Facility		$49.45	$116.18	$176.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $87.91 / $153.54 / $184.25	Professional		$87.91	$153.54	$184.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.45 / $152.85 / $799.68	Facility		$77.45	$152.85	$799.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.39 / $102.59 / $168.89	Professional		$71.39	$102.59	$168.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $49.45 / $116.18 / $176.57	Facility		$49.45	$116.18	$176.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $87.91 / $153.54 / $184.25	Professional		$87.91	$153.54	$184.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $153.54 / $236.29 / $459.69	Professional		$153.54	$236.29	$459.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $99.32 / $299.88 / $799.68	Facility		$99.32	$299.88	$799.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $99.32 / $1,019.46	Professional		$72.50	$99.32	$1,019.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $153.54 / $153.54 / $153.54	Professional		$153.54	$153.54	$153.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $122.60 / $153.54 / $153.54	Professional		$122.60	$153.54	$153.54
United Facility/Professional Professional Modifier Low / Median / High Price $61.17 / $92.12 / $153.54	Professional		$61.17	$92.12	$153.54