Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.33 / $54.33 / $54.33	Facility		$54.33	$54.33	$54.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $54.33 / $58.03	Professional		$52.75	$54.33	$58.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $52.75 / $81.76	Professional		$52.75	$52.75	$81.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.22 / $84.40 / $129.77	Facility		$72.22	$84.40	$129.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.41 / $119.67 / $169.61	Facility		$65.41	$119.67	$169.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $65.95 / $135.97	Professional		$52.75	$65.95	$135.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.96 / $52.75 / $81.50	Facility		$45.96	$52.75	$81.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.40 / $50.32 / $107.63	Facility		$39.40	$50.32	$107.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.85 / $48.85 / $102.59	Professional		$48.85	$48.85	$102.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.96 / $52.75 / $81.50	Facility		$45.96	$52.75	$81.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $58.83 / $150.56	Professional		$52.75	$58.83	$150.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $170.84 / $213.92	Facility		$65.00	$170.84	$213.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $68.56 / $213.92	Professional		$52.75	$68.56	$213.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $74.06 / $74.06	Professional		$48.40	$74.06	$74.06
United Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $52.75 / $63.30	Professional		$52.75	$52.75	$63.30