Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.40 / $85.40 / $85.40	Facility		$85.40	$85.40	$85.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.50 / $85.40 / $98.49	Professional		$41.50	$85.40	$98.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.82 / $94.82 / $116.23	Professional		$94.82	$94.82	$116.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.19 / $218.19 / $218.19	Facility		$218.19	$218.19	$218.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $273.94 / $320.12 / $363.77	Facility		$273.94	$320.12	$363.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.24 / $147.66 / $192.96	Professional		$48.24	$147.66	$192.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.02 / $86.67 / $101.96	Facility		$84.02	$86.67	$101.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.45 / $89.67 / $158.04	Facility		$74.45	$89.67	$158.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.79 / $50.87 / $95.01	Professional		$41.79	$50.87	$95.01
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 $74.45 / $85.40 / $101.96	Facility		$74.45	$85.40	$101.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.96 / $156.91 / $292.14	Professional		$101.96	$156.91	$292.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $206.98 / $206.98 / $519.66	Facility		$206.98	$206.98	$519.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.24 / $448.07 / $618.38	Professional		$48.24	$448.07	$618.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $101.96 / $101.96 / $101.96	Professional		$101.96	$101.96	$101.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $101.96 / $101.96 / $1,000,000.00	Professional		$101.96	$101.96	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $50.87 / $81.20	Professional		$39.26	$50.87	$81.20