Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.47 / $100.47 / $100.47	Facility		$100.47	$100.47	$100.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.43 / $100.47 / $168.35	Professional		$83.43	$100.47	$168.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.17 / $219.09 / $362.49	Facility		$199.17	$219.09	$362.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.26 / $185.23 / $244.97	Professional		$172.26	$185.23	$244.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.28 / $426.22 / $426.22	Facility		$143.28	$426.22	$426.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $439.82 / $831.34	Facility		$120.62	$439.82	$831.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.05 / $288.75 / $376.94	Professional		$88.05	$288.75	$376.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.30 / $150.71 / $229.05	Facility		$57.30	$150.71	$229.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $114.04 / $194.38 / $239.00	Professional		$114.04	$194.38	$239.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.19 / $199.17 / $927.48	Facility		$99.19	$199.17	$927.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.72 / $133.08 / $216.87	Professional		$89.72	$133.08	$216.87
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 $57.30 / $150.71 / $229.05	Facility		$57.30	$150.71	$229.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $114.04 / $194.38 / $239.00	Professional		$114.04	$194.38	$239.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.17 / $306.52 / $532.96	Professional		$199.17	$306.52	$532.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $389.00 / $927.48	Facility		$120.62	$389.00	$927.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.05 / $120.62 / $1,002.77	Professional		$88.05	$120.62	$1,002.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $199.17 / $199.17 / $199.17	Professional		$199.17	$199.17	$199.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $199.17 / $199.17 / $199.17	Professional		$199.17	$199.17	$199.17
United Facility/Professional Professional Modifier Low / Median / High Price $69.50 / $118.35 / $199.17	Professional		$69.50	$118.35	$199.17