Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.59 / $80.59 / $80.59	Facility		$80.59	$80.59	$80.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $80.59 / $94.62	Professional		$39.72	$80.59	$94.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.48 / $89.48 / $109.69	Professional		$89.48	$89.48	$109.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $205.91 / $205.91 / $205.91	Facility		$205.91	$205.91	$205.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $258.62 / $302.22 / $343.43	Facility		$258.62	$302.22	$343.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.19 / $139.22 / $182.11	Professional		$46.19	$139.22	$182.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $78.56 / $80.59 / $96.22	Facility		$78.56	$80.59	$96.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.27 / $84.63 / $149.13	Facility		$70.27	$84.63	$149.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.01 / $48.01 / $89.67	Professional		$40.01	$48.01	$89.67
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 $70.27 / $80.59 / $96.22	Facility		$70.27	$80.59	$96.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.22 / $148.09 / $279.48	Professional		$96.22	$148.09	$279.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $195.33 / $195.33 / $503.15	Facility		$195.33	$195.33	$503.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.19 / $422.87 / $635.09	Professional		$46.19	$422.87	$635.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $96.22 / $96.22 / $96.22	Professional		$96.22	$96.22	$96.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $96.22 / $96.22 / $1,000,000.00	Professional		$96.22	$96.22	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $48.01 / $76.44	Professional		$37.59	$48.01	$76.44