Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.42 / $109.42 / $109.42	Facility		$109.42	$109.42	$109.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.55 / $109.42 / $122.68	Professional		$53.55	$109.42	$122.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.49 / $121.49 / $148.91	Professional		$121.49	$121.49	$148.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $279.55 / $279.55 / $279.55	Facility		$279.55	$279.55	$279.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $351.44 / $410.68 / $466.68	Facility		$351.44	$410.68	$466.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.26 / $189.38 / $247.23	Professional		$62.26	$189.38	$247.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $107.65 / $109.42 / $130.63	Facility		$107.65	$109.42	$130.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.43 / $114.89 / $202.48	Facility		$95.43	$114.89	$202.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.92 / $65.17 / $121.73	Professional		$53.92	$65.17	$121.73
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 $95.43 / $109.42 / $130.63	Facility		$95.43	$109.42	$130.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $201.05 / $376.86	Professional		$130.63	$201.05	$376.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $265.18 / $321.11 / $691.38	Facility		$265.18	$321.11	$691.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.26 / $574.07 / $1,015.07	Professional		$62.26	$574.07	$1,015.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $130.63 / $130.63	Professional		$130.63	$130.63	$130.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $130.63 / $1,000,000.00	Professional		$130.63	$130.63	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $50.66 / $64.70 / $103.79	Professional		$50.66	$64.70	$103.79