Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.63 / $106.63 / $106.63	Facility		$106.63	$106.63	$106.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $97.11 / $106.63	Professional		$42.13	$97.11	$106.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.39 / $118.39 / $145.12	Professional		$118.39	$118.39	$145.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $272.42 / $272.42 / $272.42	Facility		$272.42	$272.42	$272.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $342.43 / $400.15 / $454.72	Facility		$342.43	$400.15	$454.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.97 / $184.69 / $240.94	Professional		$48.97	$184.69	$240.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $92.97 / $106.63 / $127.30	Facility		$92.97	$106.63	$127.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.45 / $111.96 / $197.32	Facility		$88.45	$111.96	$197.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.42 / $63.51 / $118.63	Professional		$42.42	$63.51	$118.63
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 $85.46 / $106.63 / $127.30	Facility		$85.46	$106.63	$127.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.48 / $190.95 / $296.04	Professional		$112.48	$190.95	$296.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $258.42 / $258.42 / $549.76	Facility		$258.42	$258.42	$549.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.97 / $559.44 / $794.30	Professional		$48.97	$559.44	$794.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.30 / $127.30 / $127.30	Professional		$127.30	$127.30	$127.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.30 / $127.30 / $1,000,000.00	Professional		$127.30	$127.30	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $39.85 / $60.86 / $105.85	Professional		$39.85	$60.86	$105.85