Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.72 / $112.72 / $112.72	Facility		$112.72	$112.72	$112.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $112.72 / $120.38	Professional		$109.44	$112.72	$120.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $164.16	Professional		$109.44	$109.44	$164.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $149.83 / $175.10 / $175.10	Facility		$149.83	$175.10	$175.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $337.07 / $616.64 / $873.99	Facility		$337.07	$616.64	$873.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.56 / $123.36 / $262.97	Professional		$108.56	$123.36	$262.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $114.91 / $188.27	Facility		$109.44	$114.91	$188.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $130.11 / $134.01 / $246.24	Facility		$130.11	$134.01	$246.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.11 / $130.11 / $1,668.00	Professional		$130.11	$130.11	$1,668.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $85.00	Professional		$50.00	$60.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $114.91 / $188.27	Facility		$109.44	$114.91	$188.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.43 / $170.35 / $662.28	Professional		$109.43	$170.35	$662.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $206.48 / $1,417.80 / $1,668.00	Facility		$206.48	$1,417.80	$1,668.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $470.48 / $1,668.00	Professional		$109.44	$470.48	$1,668.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $153.65 / $153.65 / $153.65	Professional		$153.65	$153.65	$153.65
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $153.22	Professional		$109.44	$109.44	$153.22