Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.60 / $87.60 / $87.60	Facility		$87.60	$87.60	$87.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $87.60 / $103.79	Professional		$42.95	$87.60	$103.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.26 / $97.26 / $119.22	Professional		$97.26	$97.26	$119.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.80 / $223.80 / $223.80	Facility		$223.80	$223.80	$223.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.14 / $328.55 / $373.35	Facility		$281.14	$328.55	$373.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $151.41 / $197.93	Professional		$49.92	$151.41	$197.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $86.18 / $87.60 / $104.58	Facility		$86.18	$87.60	$104.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.37 / $91.98 / $162.10	Facility		$76.37	$91.98	$162.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.24 / $52.18 / $97.45	Professional		$43.24	$52.18	$97.45
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 $76.37 / $87.60 / $104.58	Facility		$76.37	$87.60	$104.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $104.58 / $160.93 / $301.88	Professional		$104.58	$160.93	$301.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $212.30 / $212.30 / $549.29	Facility		$212.30	$212.30	$549.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $459.59 / $597.30	Professional		$49.92	$459.59	$597.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $104.58 / $104.58 / $104.58	Professional		$104.58	$104.58	$104.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $104.58 / $104.58 / $1,000,000.00	Professional		$104.58	$104.58	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $40.63 / $52.18 / $96.85	Professional		$40.63	$52.18	$96.85