Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.40 / $76.40 / $76.40	Facility		$76.40	$76.40	$76.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.42 / $76.40 / $127.97	Professional		$63.42	$76.40	$127.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.46 / $166.61 / $275.66	Facility		$151.46	$166.61	$275.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.99 / $140.86 / $186.29	Professional		$130.99	$140.86	$186.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.95 / $324.12 / $324.12	Facility		$108.95	$324.12	$324.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.15 / $334.61 / $632.60	Facility		$98.15	$334.61	$632.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $219.38 / $286.64	Professional		$71.65	$219.38	$286.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.56 / $114.60 / $174.18	Facility		$43.56	$114.60	$174.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $86.71 / $147.81 / $181.75	Professional		$86.71	$147.81	$181.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.42 / $151.46 / $705.18	Facility		$75.42	$151.46	$705.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.22 / $101.19 / $164.92	Professional		$68.22	$101.19	$164.92
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 $43.56 / $114.60 / $174.18	Facility		$43.56	$114.60	$174.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $86.71 / $147.81 / $181.75	Professional		$86.71	$147.81	$181.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.46 / $233.08 / $404.49	Professional		$151.46	$233.08	$404.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $98.15 / $295.82 / $705.18	Facility		$98.15	$295.82	$705.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $98.15 / $762.34	Professional		$71.65	$98.15	$762.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $151.46 / $151.46 / $151.46	Professional		$151.46	$151.46	$151.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $151.46 / $151.46 / $151.46	Professional		$151.46	$151.46	$151.46
United Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $100.74 / $151.46	Professional		$60.34	$100.74	$151.46