Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.09 / $92.09 / $92.09	Facility		$92.09	$92.09	$92.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $92.09 / $98.35	Professional		$89.41	$92.09	$98.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $146.63	Professional		$89.41	$89.41	$146.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $122.41 / $142.16 / $143.06	Facility		$122.41	$142.16	$143.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.16 / $247.27 / $350.46	Facility		$135.16	$247.27	$350.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $117.23 / $153.34	Professional		$89.41	$117.23	$153.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $93.11 / $140.90	Facility		$89.41	$93.11	$140.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.11 / $95.90 / $172.62	Facility		$93.11	$95.90	$172.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $93.11 / $225.11	Professional		$93.11	$93.11	$225.11
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 $89.41 / $93.11 / $140.90	Facility		$89.41	$93.11	$140.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $102.82 / $213.84	Professional		$89.41	$102.82	$213.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $92.03 / $225.00 / $384.93	Facility		$92.03	$225.00	$384.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $191.25 / $436.14	Professional		$89.41	$191.25	$436.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $125.53 / $125.53 / $125.53	Professional		$125.53	$125.53	$125.53
United Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $122.42	Professional		$89.41	$89.41	$122.42