Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.34 / $123.34 / $123.34	Facility		$123.34	$123.34	$123.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $116.61 / $139.01	Professional		$54.99	$116.61	$139.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $136.94 / $167.86	Professional		$136.94	$136.94	$167.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $315.12 / $315.12 / $315.12	Facility		$315.12	$315.12	$315.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $395.59 / $462.28 / $525.32	Facility		$395.59	$462.28	$525.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.92 / $213.28 / $278.69	Professional		$63.92	$213.28	$278.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $121.35 / $123.34 / $147.25	Facility		$121.35	$123.34	$147.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.54 / $129.51 / $228.24	Facility		$107.54	$129.51	$228.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.37 / $73.45 / $137.22	Professional		$55.37	$73.45	$137.22
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 $107.54 / $123.34 / $147.25	Facility		$107.54	$123.34	$147.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $146.88 / $220.88 / $386.60	Professional		$146.88	$220.88	$386.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $298.92 / $298.92 / $734.76	Facility		$298.92	$298.92	$734.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.92 / $647.10 / $871.65	Professional		$63.92	$647.10	$871.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.25 / $147.25 / $147.25	Professional		$147.25	$147.25	$147.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.25 / $147.25 / $1,000,000.00	Professional		$147.25	$147.25	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $52.02 / $73.42 / $116.98	Professional		$52.02	$73.42	$116.98