Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.80 / $88.80 / $88.80	Facility		$88.80	$88.80	$88.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.77 / $88.80 / $99.59	Professional		$43.77	$88.80	$99.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.60 / $98.60 / $120.86	Professional		$98.60	$98.60	$120.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $226.88 / $226.88 / $226.88	Facility		$226.88	$226.88	$226.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $284.75 / $332.76 / $378.13	Facility		$284.75	$332.76	$378.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.89 / $153.75 / $200.64	Professional		$50.89	$153.75	$200.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $87.37 / $88.80 / $106.02	Facility		$87.37	$88.80	$106.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.43 / $93.24 / $164.33	Facility		$77.43	$93.24	$164.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.08 / $52.89 / $98.79	Professional		$44.08	$52.89	$98.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.27 / $58.40 / $70.00	Professional		$25.27	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $77.43 / $88.80 / $106.02	Facility		$77.43	$88.80	$106.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.02 / $163.15 / $307.72	Professional		$106.02	$163.15	$307.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $215.22 / $287.42 / $561.92	Facility		$215.22	$287.42	$561.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.89 / $465.89 / $908.69	Professional		$50.89	$465.89	$908.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $106.02 / $106.02 / $106.02	Professional		$106.02	$106.02	$106.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $106.02 / $106.02 / $1,000,000.00	Professional		$106.02	$106.02	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $52.89 / $84.22	Professional		$41.41	$52.89	$84.22