Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.18 / $110.18 / $110.18	Facility		$110.18	$110.18	$110.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $110.18 / $117.66	Professional		$106.97	$110.18	$117.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $165.80	Professional		$106.97	$106.97	$165.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $146.44 / $170.08 / $171.15	Facility		$146.44	$170.08	$171.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.32 / $101.20 / $143.43	Facility		$55.32	$101.20	$143.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $69.91 / $106.97	Professional		$39.75	$69.91	$106.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.75 / $110.18 / $168.58	Facility		$64.75	$110.18	$168.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.75 / $66.69 / $112.05	Facility		$64.75	$66.69	$112.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.75 / $64.75 / $135.97	Professional		$64.75	$64.75	$135.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.75 / $110.18 / $168.58	Facility		$64.75	$110.18	$168.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $106.96 / $132.87	Professional		$50.29	$106.96	$132.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $112.05 / $167.68	Facility		$65.00	$112.05	$167.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.24 / $106.97 / $252.11	Professional		$95.24	$106.97	$252.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $150.19 / $150.19 / $150.19	Professional		$150.19	$150.19	$150.19
United Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $128.36	Professional		$106.97	$106.97	$128.36