Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.11 / $118.11 / $118.11	Facility		$118.11	$118.11	$118.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.15 / $118.11 / $196.11	Professional		$73.15	$118.11	$196.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.13 / $257.54 / $426.12	Facility		$234.13	$257.54	$426.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $210.71 / $217.74 / $287.97	Professional		$210.71	$217.74	$287.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $168.44 / $501.04 / $501.04	Facility		$168.44	$501.04	$501.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $484.06 / $976.90	Facility		$113.00	$484.06	$976.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.49 / $339.38 / $443.10	Professional		$82.49	$339.38	$443.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.56 / $177.17 / $269.25	Facility		$56.56	$177.17	$269.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $134.06 / $210.16 / $280.95	Professional		$134.06	$210.16	$280.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.90 / $233.80 / $917.84	Facility		$97.90	$233.80	$917.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.28 / $131.99 / $254.94	Professional		$93.28	$131.99	$254.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $158.00	Professional		$50.00	$70.00	$158.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.56 / $177.17 / $269.25	Facility		$56.56	$177.17	$269.25
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $134.06 / $210.16 / $280.95	Professional		$134.06	$210.16	$280.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $234.13 / $351.20 / $525.94	Professional		$234.13	$351.20	$525.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $457.28 / $917.84	Facility		$113.00	$457.28	$917.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.49 / $113.00 / $1,095.59	Professional		$82.49	$113.00	$1,095.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $234.13 / $234.13 / $234.13	Professional		$234.13	$234.13	$234.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $234.13 / $234.13 / $234.13	Professional		$234.13	$234.13	$234.13
United Facility/Professional Professional Modifier Low / Median / High Price $77.87 / $124.65 / $200.80	Professional		$77.87	$124.65	$200.80