Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.77 / $104.77 / $104.77	Facility		$104.77	$104.77	$104.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $104.77 / $111.89	Professional		$101.72	$104.77	$111.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $157.66	Professional		$101.72	$101.72	$157.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $139.27 / $161.72 / $162.75	Facility		$139.27	$161.72	$162.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.97 / $263.39 / $373.33	Facility		$143.97	$263.39	$373.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $130.13 / $220.31	Professional		$101.72	$130.13	$220.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $100.72 / $104.77 / $160.30	Facility		$100.72	$104.77	$160.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.72 / $103.74 / $186.73	Facility		$100.72	$103.74	$186.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.72 / $100.72 / $293.52	Professional		$100.72	$100.72	$293.52
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 $100.72 / $104.77 / $160.30	Facility		$100.72	$104.77	$160.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $128.35 / $285.91	Professional		$101.72	$128.35	$285.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $102.18 / $229.98 / $515.16	Facility		$102.18	$229.98	$515.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $165.12 / $515.16	Professional		$101.72	$165.12	$515.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $142.81 / $142.81 / $142.81	Professional		$142.81	$142.81	$142.81
United Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $132.24	Professional		$101.72	$101.72	$132.24