Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.08 / $76.08 / $76.08	Facility		$76.08	$76.08	$76.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.41 / $76.08 / $140.06	Professional		$69.41	$76.08	$140.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.80 / $165.88 / $274.45	Facility		$150.80	$165.88	$274.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.72 / $140.24 / $185.48	Professional		$135.72	$140.24	$185.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.49 / $322.70 / $322.70	Facility		$108.49	$322.70	$322.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.54 / $311.44 / $629.79	Facility		$97.54	$311.44	$629.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.20 / $218.44 / $285.41	Professional		$71.20	$218.44	$285.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $46.88 / $114.12 / $173.42	Facility		$46.88	$114.12	$173.42
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $86.34 / $150.80 / $194.08	Professional		$86.34	$150.80	$194.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.08 / $150.80 / $771.31	Facility		$76.08	$150.80	$771.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.12 / $100.75 / $170.23	Professional		$70.12	$100.75	$170.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $91.74	Professional		$50.00	$65.00	$91.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $46.88 / $114.12 / $173.42	Facility		$46.88	$114.12	$173.42
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $86.34 / $150.80 / $194.08	Professional		$86.34	$150.80	$194.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $150.80 / $232.09 / $435.61	Professional		$150.80	$232.09	$435.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $97.54 / $294.54 / $771.31	Facility		$97.54	$294.54	$771.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.20 / $97.54 / $996.17	Professional		$71.20	$97.54	$996.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $150.80 / $150.80 / $150.80	Professional		$150.80	$150.80	$150.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $120.40 / $150.80 / $150.80	Professional		$120.40	$150.80	$150.80
United Facility/Professional Professional Modifier Low / Median / High Price $60.08 / $96.13 / $133.71	Professional		$60.08	$96.13	$133.71