Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.10 / $211.10 / $211.10	Facility		$211.10	$211.10	$211.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $211.10 / $225.45	Professional		$204.96	$211.10	$225.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $317.68	Professional		$204.96	$204.96	$317.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $280.61 / $325.89 / $327.94	Facility		$280.61	$325.89	$327.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $352.39 / $644.66 / $913.71	Facility		$352.39	$644.66	$913.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $334.88 / $697.03	Professional		$204.96	$334.88	$697.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $215.20 / $353.15	Facility		$204.96	$215.20	$353.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $235.17 / $242.23 / $436.01	Facility		$235.17	$242.23	$436.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $235.17 / $235.17 / $1,266.59	Professional		$235.17	$235.17	$1,266.59
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 $204.96 / $215.20 / $353.15	Facility		$204.96	$215.20	$353.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $204.95 / $301.18 / $1,059.60	Professional		$204.95	$301.18	$1,059.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $262.93 / $1,076.67 / $1,266.67	Facility		$262.93	$1,076.67	$1,266.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $569.17 / $1,778.96	Professional		$204.96	$569.17	$1,778.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $287.76 / $287.76 / $287.76	Professional		$287.76	$287.76	$287.76
United Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $266.45	Professional		$204.96	$204.96	$266.45