Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.25 / $88.25 / $88.25	Facility		$88.25	$88.25	$88.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.36 / $91.19 / $130.19	Professional		$85.36	$91.19	$130.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.99 / $151.99 / $250.78	Facility		$151.99	$151.99	$250.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.35 / $151.99 / $173.26	Professional		$141.35	$151.99	$173.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.99 / $325.26 / $325.26	Facility		$151.99	$325.26	$325.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.21 / $477.02 / $634.00	Facility		$408.21	$477.02	$634.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $220.31 / $287.66	Professional		$62.01	$220.31	$287.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.16 / $123.55 / $151.99	Facility		$84.16	$123.55	$151.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $69.48 / $151.99	Professional		$69.48	$69.48	$151.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.36 / $123.55 / $159.59	Facility		$85.36	$123.55	$159.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.12 / $83.59 / $234.68	Professional		$70.12	$83.59	$234.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $88.30	Professional		$50.00	$70.00	$88.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $84.16 / $125.25 / $151.99	Facility		$84.16	$125.25	$151.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $69.48 / $151.99	Professional		$69.48	$69.48	$151.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.99 / $227.99 / $399.00	Professional		$151.99	$227.99	$399.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $296.86 / $308.54 / $711.31	Facility		$296.86	$308.54	$711.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $667.94 / $835.71	Professional		$62.01	$667.94	$835.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $151.99 / $151.99 / $151.99	Professional		$151.99	$151.99	$151.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.97 / $151.99 / $151.99	Professional		$123.97	$151.99	$151.99
United Facility/Professional Professional Modifier Low / Median / High Price $64.45 / $75.83 / $145.34	Professional		$64.45	$75.83	$145.34