Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.44 / $92.44 / $92.44	Facility		$92.44	$92.44	$92.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $92.44 / $98.72	Professional		$89.75	$92.44	$98.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $134.62	Professional		$89.75	$89.75	$134.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $122.88 / $143.60 / $143.60	Facility		$122.88	$143.60	$143.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.59 / $165.72 / $234.88	Facility		$90.59	$165.72	$234.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.36 / $91.45 / $130.53	Professional		$75.36	$91.45	$130.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $92.44 / $141.43	Facility		$82.41	$92.44	$141.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $84.89 / $152.80	Facility		$82.41	$84.89	$152.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.41 / $82.41 / $1,667.54	Professional		$82.41	$82.41	$1,667.54
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 $82.41 / $92.44 / $141.43	Facility		$82.41	$92.44	$141.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $97.37 / $179.78	Professional		$89.75	$97.37	$179.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $71.81 / $1,417.80 / $1,668.00	Facility		$71.81	$1,417.80	$1,668.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $103.89 / $1,668.00	Professional		$89.75	$103.89	$1,668.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $126.01 / $126.01 / $126.01	Professional		$126.01	$126.01	$126.01
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $116.68	Professional		$89.75	$89.75	$116.68