Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.86 / $67.86 / $67.86	Facility		$67.86	$67.86	$67.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $67.86 / $72.47	Professional		$65.88	$67.86	$72.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $108.04	Professional		$65.88	$65.88	$108.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $90.20 / $104.75 / $105.41	Facility		$90.20	$104.75	$105.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.62 / $162.11 / $229.77	Facility		$88.62	$162.11	$229.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.95 / $83.77	Professional		$65.88	$65.95	$83.77
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $67.86 / $113.63	Facility		$65.88	$67.86	$113.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.34 / $68.34 / $146.13	Facility		$66.34	$68.34	$146.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $66.34 / $179.98	Professional		$66.34	$66.34	$179.98
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 $65.88 / $67.86 / $113.63	Facility		$65.88	$67.86	$113.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $70.45 / $158.44	Professional		$65.88	$70.45	$158.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $178.50 / $360.00	Facility		$65.00	$178.50	$360.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $169.93 / $3,978.60	Professional		$65.88	$169.93	$3,978.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.50 / $92.50 / $92.50	Professional		$92.50	$92.50	$92.50
United Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $90.20	Professional		$65.88	$65.88	$90.20