Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.28 / $78.28 / $78.28	Facility		$78.28	$78.28	$78.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.59 / $78.28 / $89.93	Professional		$38.59	$78.28	$89.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.91 / $86.91 / $106.53	Professional		$86.91	$86.91	$106.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.98 / $199.98 / $199.98	Facility		$199.98	$199.98	$199.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.41 / $293.80 / $333.86	Facility		$251.41	$293.80	$333.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.86 / $135.47 / $176.86	Professional		$44.86	$135.47	$176.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $76.56 / $78.28 / $93.45	Facility		$76.56	$78.28	$93.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.25 / $82.19 / $144.85	Facility		$68.25	$82.19	$144.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.85 / $46.62 / $87.08	Professional		$38.85	$46.62	$87.08
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 $68.25 / $78.28 / $93.45	Facility		$68.25	$78.28	$93.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.45 / $143.82 / $271.69	Professional		$93.45	$143.82	$271.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $189.70 / $189.70 / $486.44	Facility		$189.70	$189.70	$486.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.86 / $410.67 / $529.40	Professional		$44.86	$410.67	$529.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.45 / $93.45 / $93.45	Professional		$93.45	$93.45	$93.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.45 / $93.45 / $1,000,000.00	Professional		$93.45	$93.45	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $46.62 / $77.70	Professional		$36.50	$46.62	$77.70