Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.54 / $70.54 / $70.54	Facility		$70.54	$70.54	$70.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $70.54 / $75.34	Professional		$68.48	$70.54	$75.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $102.73	Professional		$68.48	$68.48	$102.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.77 / $108.90 / $109.58	Facility		$93.77	$108.90	$109.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.81 / $193.56 / $274.33	Facility		$105.81	$193.56	$274.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $87.23 / $121.39	Professional		$68.48	$87.23	$121.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $70.54 / $107.93	Facility		$68.48	$70.54	$107.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $70.54 / $154.10	Facility		$68.48	$70.54	$154.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $143.83	Professional		$68.48	$68.48	$143.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $70.54 / $107.93	Facility		$68.48	$70.54	$107.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $78.76 / $171.98	Professional		$68.48	$78.76	$171.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $79.06 / $85.00 / $302.37	Facility		$79.06	$85.00	$302.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $108.16 / $302.37	Professional		$68.48	$108.16	$302.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $96.16 / $96.16 / $96.16	Professional		$96.16	$96.16	$96.16
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $82.19	Professional		$68.48	$68.48	$82.19