Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.72 / $81.72 / $81.72	Facility		$81.72	$81.72	$81.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.18 / $81.72 / $89.59	Professional		$38.18	$81.72	$89.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $90.73 / $111.21	Professional		$90.73	$90.73	$111.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $208.78 / $208.78 / $208.78	Facility		$208.78	$208.78	$208.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $262.23 / $306.43 / $348.22	Facility		$262.23	$306.43	$348.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.38 / $141.56 / $184.64	Professional		$44.38	$141.56	$184.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $77.45 / $81.72 / $97.56	Facility		$77.45	$81.72	$97.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.23 / $85.81 / $151.22	Facility		$71.23	$85.81	$151.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.44 / $48.67 / $90.91	Professional		$38.44	$48.67	$90.91
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 $71.23 / $81.72 / $97.56	Facility		$71.23	$81.72	$97.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.56 / $147.66 / $268.77	Professional		$97.56	$147.66	$268.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $198.05 / $198.05 / $481.56	Facility		$198.05	$198.05	$481.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.38 / $428.72 / $613.92	Professional		$44.38	$428.72	$613.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.56 / $97.56 / $97.56	Professional		$97.56	$97.56	$97.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.56 / $97.56 / $1,000,000.00	Professional		$97.56	$97.56	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $46.64 / $77.50	Professional		$36.11	$46.64	$77.50