Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.49 / $114.49 / $114.49	Facility		$114.49	$114.49	$114.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $114.49 / $122.27	Professional		$111.15	$114.49	$122.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $166.72	Professional		$111.15	$111.15	$166.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $152.16 / $177.84 / $177.84	Facility		$152.16	$177.84	$177.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $458.94 / $839.57 / $1,189.97	Facility		$458.94	$839.57	$1,189.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $423.38 / $563.28	Professional		$111.15	$423.38	$563.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $116.71 / $191.62	Facility		$111.15	$116.71	$191.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $130.26 / $134.16 / $250.09	Facility		$130.26	$134.16	$250.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.26 / $130.26 / $398.91	Professional		$130.26	$130.26	$398.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $116.71 / $191.62	Facility		$111.15	$116.71	$191.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $173.02 / $891.00	Professional		$111.15	$173.02	$891.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $332.42 / $474.00 / $1,606.18	Facility		$332.42	$474.00	$1,606.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $514.79 / $1,606.18	Professional		$111.15	$514.79	$1,606.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $156.05 / $156.05 / $156.05	Professional		$156.05	$156.05	$156.05
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $144.50	Professional		$111.15	$111.15	$144.50