Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.24 / $118.24 / $118.24	Facility		$118.24	$118.24	$118.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.29 / $118.24 / $151.61	Professional		$58.29	$118.24	$151.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.28 / $131.28 / $166.56	Professional		$131.28	$131.28	$166.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.08 / $302.08 / $302.08	Facility		$302.08	$302.08	$302.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $379.37 / $443.33 / $503.78	Facility		$379.37	$443.33	$503.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.76 / $204.38 / $267.14	Professional		$67.76	$204.38	$267.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $115.26 / $118.24 / $141.16	Facility		$115.26	$118.24	$141.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.09 / $124.15 / $218.80	Facility		$103.09	$124.15	$218.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.69 / $70.42 / $131.54	Professional		$58.69	$70.42	$131.54
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 $103.09 / $118.24 / $141.16	Facility		$103.09	$118.24	$141.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.16 / $217.24 / $409.97	Professional		$141.16	$217.24	$409.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $286.55 / $286.55 / $750.39	Facility		$286.55	$286.55	$750.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.76 / $620.33 / $851.58	Professional		$67.76	$620.33	$851.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $141.16 / $141.16 / $141.16	Professional		$141.16	$141.16	$141.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $141.16 / $141.16 / $1,000,000.00	Professional		$141.16	$141.16	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $55.14 / $70.42 / $112.44	Professional		$55.14	$70.42	$112.44