Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.70 / $73.70 / $73.70	Facility		$73.70	$73.70	$73.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $73.70 / $78.70	Professional		$71.55	$73.70	$78.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $107.32	Professional		$71.55	$71.55	$107.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.96 / $114.48 / $114.48	Facility		$97.96	$114.48	$114.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.34 / $92.09 / $130.53	Facility		$50.34	$92.09	$130.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $66.64 / $71.55	Professional		$39.47	$66.64	$71.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.14 / $71.55 / $110.55	Facility		$25.14	$71.55	$110.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.14 / $72.27 / $110.55	Facility		$25.14	$72.27	$110.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $150.26	Professional		$71.55	$71.55	$150.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $174.58	Professional		$50.00	$70.00	$174.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.14 / $71.55 / $110.55	Facility		$25.14	$71.55	$110.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.05 / $71.55 / $110.90	Professional		$52.05	$71.55	$110.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $71.55 / $104.18 / $390.68	Facility		$71.55	$104.18	$390.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $110.43 / $395.88	Professional		$71.55	$110.43	$395.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $29.11 / $100.46 / $100.46	Professional		$29.11	$100.46	$100.46
United Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $85.86	Professional		$71.55	$71.55	$85.86