Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.44 / $82.44 / $82.44	Facility		$82.44	$82.44	$82.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $82.44 / $88.04	Professional		$80.04	$82.44	$88.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $144.07	Professional		$80.04	$80.04	$144.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.58 / $128.06 / $128.06	Facility		$109.58	$128.06	$128.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $835.56 / $1,528.57 / $2,166.51	Facility		$835.56	$1,528.57	$2,166.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $81.56 / $103.58	Professional		$80.04	$81.56	$103.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $82.44 / $137.58	Facility		$80.04	$82.44	$137.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $82.44 / $176.06	Facility		$80.04	$82.44	$176.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $589.20	Professional		$80.04	$80.04	$589.20
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 $80.04 / $82.44 / $137.58	Facility		$80.04	$82.44	$137.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $124.06 / $1,937.14	Professional		$80.04	$124.06	$1,937.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $677.35 / $2,756.52	Facility		$80.04	$677.35	$2,756.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $1,148.55 / $2,756.52	Professional		$80.04	$1,148.55	$2,756.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.38 / $112.38 / $112.38	Professional		$112.38	$112.38	$112.38
United Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $168.08	Professional		$80.04	$80.04	$168.08