Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.71 / $105.71 / $105.71	Facility		$105.71	$105.71	$105.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.60 / $102.10 / $126.49	Professional		$49.60	$102.10	$126.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.37 / $117.37 / $143.86	Professional		$117.37	$117.37	$143.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $270.07 / $270.07 / $270.07	Facility		$270.07	$270.07	$270.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.82 / $395.94 / $449.93	Facility		$338.82	$395.94	$449.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $182.81 / $238.84	Professional		$57.66	$182.81	$238.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $100.61 / $105.71 / $126.20	Facility		$100.61	$105.71	$126.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $92.16 / $111.00 / $195.61	Facility		$92.16	$111.00	$195.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.94 / $62.96 / $117.60	Professional		$49.94	$62.96	$117.60
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 $92.16 / $105.71 / $126.20	Facility		$92.16	$105.71	$126.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $126.20 / $191.53 / $348.62	Professional		$126.20	$191.53	$348.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $256.19 / $272.00 / $641.86	Facility		$256.19	$272.00	$641.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $554.58 / $859.86	Professional		$57.66	$554.58	$859.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $126.20 / $126.20 / $126.20	Professional		$126.20	$126.20	$126.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $126.20 / $126.20 / $1,000,000.00	Professional		$126.20	$126.20	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $46.92 / $62.96 / $104.94	Professional		$46.92	$62.96	$104.94