Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.70 / $77.70 / $77.70	Facility		$77.70	$77.70	$77.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $77.70 / $90.76	Professional		$37.79	$77.70	$90.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $86.29 / $105.76	Professional		$86.29	$86.29	$105.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $198.55 / $198.55 / $198.55	Facility		$198.55	$198.55	$198.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $249.61 / $291.69 / $331.47	Facility		$249.61	$291.69	$331.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $134.53 / $175.60	Professional		$43.93	$134.53	$175.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $76.45 / $77.70 / $92.78	Facility		$76.45	$77.70	$92.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.76 / $81.59 / $143.81	Facility		$67.76	$81.59	$143.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $46.29 / $86.46	Professional		$38.04	$46.29	$86.46
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 $67.76 / $77.70 / $92.78	Facility		$67.76	$77.70	$92.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.78 / $142.80 / $265.85	Professional		$92.78	$142.80	$265.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $188.34 / $188.34 / $481.81	Facility		$188.34	$188.34	$481.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $407.75 / $607.76	Professional		$43.93	$407.75	$607.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.78 / $92.78 / $92.78	Professional		$92.78	$92.78	$92.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.78 / $92.78 / $1,000,000.00	Professional		$92.78	$92.78	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $35.75 / $45.66 / $73.90	Professional		$35.75	$45.66	$73.90