Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.43 / $53.43 / $53.43	Facility		$53.43	$53.43	$53.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.56 / $48.58 / $53.43	Professional		$22.56	$48.58	$53.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $59.33 / $72.73	Professional		$59.33	$59.33	$72.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $136.53 / $136.53 / $136.53	Facility		$136.53	$136.53	$136.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.21 / $200.08 / $227.36	Facility		$171.21	$200.08	$227.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $92.34 / $120.74	Professional		$26.22	$92.34	$120.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $46.60 / $53.43 / $63.80	Facility		$46.60	$53.43	$63.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.75 / $56.10 / $98.89	Facility		$45.75	$56.10	$98.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.71 / $31.82 / $59.44	Professional		$22.71	$31.82	$59.44
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 $45.75 / $53.43 / $63.80	Facility		$45.75	$53.43	$63.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.31 / $95.70 / $158.72	Professional		$60.31	$95.70	$158.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $129.51 / $129.51 / $287.73	Facility		$129.51	$129.51	$287.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $280.35 / $347.90	Professional		$26.22	$280.35	$347.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.80 / $63.80 / $63.80	Professional		$63.80	$63.80	$63.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.80 / $63.80 / $1,000,000.00	Professional		$63.80	$63.80	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $21.34 / $30.50 / $53.04	Professional		$21.34	$30.50	$53.04