Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.65 / $187.65 / $187.65	Facility		$187.65	$187.65	$187.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $187.65 / $200.40	Professional		$182.18	$187.65	$200.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $282.37	Professional		$182.18	$182.18	$282.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $249.42 / $289.67 / $291.49	Facility		$249.42	$289.67	$291.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $240.97 / $440.83 / $624.80	Facility		$240.97	$440.83	$624.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $232.03 / $298.88	Professional		$182.18	$232.03	$298.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $182.18 / $187.65 / $287.10	Facility		$182.18	$187.65	$287.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $182.18 / $187.65 / $337.77	Facility		$182.18	$187.65	$337.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $560.97	Professional		$182.18	$182.18	$560.97
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 $182.18 / $187.65 / $287.10	Facility		$182.18	$187.65	$287.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $209.51 / $445.90	Professional		$182.18	$209.51	$445.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $182.18 / $447.50 / $804.35	Facility		$182.18	$447.50	$804.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $257.81 / $804.35	Professional		$182.18	$257.81	$804.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $255.78 / $255.78 / $255.78	Professional		$255.78	$255.78	$255.78
United Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $236.83	Professional		$182.18	$182.18	$236.83