Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.49 / $91.49 / $91.49	Facility		$91.49	$91.49	$91.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $88.37 / $114.17	Professional		$42.44	$88.37	$114.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.58 / $101.58 / $124.52	Professional		$101.58	$101.58	$124.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $233.75 / $233.75 / $233.75	Facility		$233.75	$233.75	$233.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $293.77 / $343.29 / $390.10	Facility		$293.77	$343.29	$390.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.33 / $158.44 / $206.73	Professional		$49.33	$158.44	$206.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $86.09 / $91.49 / $109.23	Facility		$86.09	$91.49	$109.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.78 / $96.06 / $169.31	Facility		$79.78	$96.06	$169.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.73 / $54.50 / $101.79	Professional		$42.73	$54.50	$101.79
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 $79.78 / $91.49 / $109.23	Facility		$79.78	$91.49	$109.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.23 / $164.25 / $298.95	Professional		$109.23	$164.25	$298.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $221.74 / $221.74 / $537.64	Facility		$221.74	$221.74	$537.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.33 / $480.02 / $553.72	Professional		$49.33	$480.02	$553.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.23 / $109.23 / $109.23	Professional		$109.23	$109.23	$109.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.23 / $109.23 / $1,000,000.00	Professional		$109.23	$109.23	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $54.50 / $90.02	Professional		$40.15	$54.50	$90.02