Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.65 / $77.65 / $77.65	Facility		$77.65	$77.65	$77.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.78 / $64.42 / $77.65	Professional		$28.78	$64.42	$77.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.21 / $86.21 / $105.67	Professional		$86.21	$86.21	$105.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $198.38 / $198.38 / $198.38	Facility		$198.38	$198.38	$198.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $248.71 / $290.64 / $330.27	Facility		$248.71	$290.64	$330.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.45 / $134.53 / $175.45	Professional		$33.45	$134.53	$175.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $67.70 / $77.65 / $92.70	Facility		$67.70	$77.65	$92.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.42 / $81.14 / $143.38	Facility		$64.42	$81.14	$143.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.84 / $46.25 / $86.39	Professional		$30.84	$46.25	$86.39
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 $58.37 / $77.65 / $92.70	Facility		$58.37	$77.65	$92.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.95 / $139.05 / $202.55	Professional		$76.95	$139.05	$202.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $188.18 / $188.18 / $368.60	Facility		$188.18	$188.18	$368.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.45 / $407.39 / $462.69	Professional		$33.45	$407.39	$462.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $92.70 / $92.70	Professional		$92.70	$92.70	$92.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $92.70 / $1,000,000.00	Professional		$92.70	$92.70	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $27.22 / $44.32 / $77.09	Professional		$27.22	$44.32	$77.09