Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.27 / $66.27 / $66.27	Facility		$66.27	$66.27	$66.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.63 / $68.26 / $83.60	Professional		$62.63	$68.26	$83.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $196.44 / $229.56 / $305.11	Facility		$196.44	$229.56	$305.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.04 / $103.35 / $140.81	Professional		$69.04	$103.35	$140.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $74.05 / $136.30	Facility		$63.00	$74.05	$136.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.78 / $78.22 / $141.00	Facility		$61.78	$78.22	$141.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.78 / $143.05 / $493.61	Professional		$83.78	$143.05	$493.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $65.14 / $137.47	Professional		$41.40	$65.14	$137.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $74.41 / $141.00	Facility		$63.00	$74.41	$141.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $116.84 / $183.00 / $250.98	Professional		$116.84	$183.00	$250.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $92.30 / $145.32 / $390.66	Facility		$92.30	$145.32	$390.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.04 / $389.45 / $493.61	Professional		$69.04	$389.45	$493.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.24 / $92.24 / $92.24	Professional		$92.24	$92.24	$92.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $129.97 / $157.58 / $157.58	Professional		$129.97	$157.58	$157.58
United Facility/Professional Professional Modifier Low / Median / High Price $82.75 / $144.21 / $210.51	Professional		$82.75	$144.21	$210.51