Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.25 / $88.25 / $88.25	Facility		$88.25	$88.25	$88.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.13 / $80.22 / $88.25	Professional		$38.13	$80.22	$88.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.98 / $97.98 / $120.11	Professional		$97.98	$97.98	$120.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $225.47 / $225.47 / $225.47	Facility		$225.47	$225.47	$225.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $282.95 / $330.65 / $375.74	Facility		$282.95	$330.65	$375.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.32 / $152.81 / $199.40	Professional		$44.32	$152.81	$199.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $77.34 / $88.25 / $105.36	Facility		$77.34	$88.25	$105.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.93 / $92.66 / $163.31	Facility		$76.93	$92.66	$163.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.39 / $52.55 / $98.17	Professional		$38.39	$52.55	$98.17
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 $76.93 / $88.25 / $105.36	Facility		$76.93	$88.25	$105.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.75 / $158.04 / $267.80	Professional		$101.75	$158.04	$267.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $213.88 / $213.88 / $486.72	Facility		$213.88	$213.88	$486.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.32 / $463.01 / $601.62	Professional		$44.32	$463.01	$601.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.36 / $105.36 / $105.36	Professional		$105.36	$105.36	$105.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.36 / $105.36 / $1,000,000.00	Professional		$105.36	$105.36	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $36.07 / $50.36 / $83.91	Professional		$36.07	$50.36	$83.91