Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.95 / $119.95 / $119.95	Facility		$119.95	$119.95	$119.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.14 / $119.95 / $153.82	Professional		$59.14	$119.95	$153.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.19 / $133.19 / $163.25	Professional		$133.19	$133.19	$163.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $306.47 / $306.47 / $306.47	Facility		$306.47	$306.47	$306.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $384.78 / $449.64 / $510.96	Facility		$384.78	$449.64	$510.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $207.66 / $271.02	Professional		$68.73	$207.66	$271.02
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $118.02 / $119.95 / $143.21	Facility		$118.02	$119.95	$143.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.60 / $125.95 / $221.98	Facility		$104.60	$125.95	$221.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.54 / $71.45 / $133.44	Professional		$59.54	$71.45	$133.44
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 $104.60 / $119.95 / $143.21	Facility		$104.60	$119.95	$143.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $143.21 / $220.40 / $415.81	Professional		$143.21	$220.40	$415.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $290.72 / $290.72 / $765.27	Facility		$290.72	$290.72	$765.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $629.33 / $897.48	Professional		$68.73	$629.33	$897.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $143.21 / $143.21 / $143.21	Professional		$143.21	$143.21	$143.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $143.21 / $143.21 / $1,000,000.00	Professional		$143.21	$143.21	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $55.94 / $71.45 / $119.08	Professional		$55.94	$71.45	$119.08