Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.04 / $109.04 / $109.04	Facility		$109.04	$109.04	$109.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.53 / $109.04 / $182.68	Professional		$90.53	$109.04	$182.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $216.16 / $237.78 / $393.41	Facility		$216.16	$237.78	$393.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.77 / $201.03 / $265.87	Professional		$198.77	$201.03	$265.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $155.50 / $462.58 / $462.58	Facility		$155.50	$462.58	$462.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.65 / $476.87 / $902.72	Facility		$171.65	$476.87	$902.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.90 / $313.13 / $409.09	Professional		$145.90	$313.13	$409.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.04 / $172.93 / $248.58	Facility		$109.04	$172.93	$248.58
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $210.96 / $216.16 / $259.39	Professional		$210.96	$216.16	$259.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.47 / $216.16 / $1,006.76	Facility		$141.47	$216.16	$1,006.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $99.22 / $145.01 / $236.64	Professional		$99.22	$145.01	$236.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $99.25	Professional		$50.00	$65.00	$99.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $109.04 / $172.93 / $248.58	Facility		$109.04	$172.93	$248.58
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $210.96 / $216.16 / $259.39	Professional		$210.96	$216.16	$259.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $216.16 / $332.68 / $578.13	Professional		$216.16	$332.68	$578.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $171.65 / $422.18 / $1,006.76	Facility		$171.65	$422.18	$1,006.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $145.90 / $171.65 / $1,090.36	Professional		$145.90	$171.65	$1,090.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $216.16 / $216.16 / $216.16	Professional		$216.16	$216.16	$216.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $216.16 / $216.16 / $216.16	Professional		$216.16	$216.16	$216.16
United Facility/Professional Professional Modifier Low / Median / High Price $80.30 / $129.96 / $191.65	Professional		$80.30	$129.96	$191.65