Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.90 / $122.90 / $122.90	Facility		$122.90	$122.90	$122.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.69 / $111.73 / $122.90	Professional		$51.69	$111.73	$122.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.46 / $136.46 / $167.27	Professional		$136.46	$136.46	$167.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $314.00 / $314.00 / $314.00	Facility		$314.00	$314.00	$314.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $394.69 / $461.23 / $524.12	Facility		$394.69	$461.23	$524.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.08 / $212.81 / $277.70	Professional		$60.08	$212.81	$277.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $114.62 / $123.15 / $146.72	Facility		$114.62	$123.15	$146.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.17 / $128.43 / $227.43	Facility		$107.17	$128.43	$227.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $73.20 / $136.72	Professional		$52.04	$73.20	$136.72
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 $107.17 / $122.90 / $146.72	Facility		$107.17	$122.90	$146.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.01 / $220.10 / $363.23	Professional		$138.01	$220.10	$363.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $297.86 / $297.86 / $685.20	Facility		$297.86	$297.86	$685.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.08 / $644.80 / $801.07	Professional		$60.08	$644.80	$801.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $146.72 / $146.72 / $146.72	Professional		$146.72	$146.72	$146.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $146.72 / $146.72 / $1,000,000.00	Professional		$146.72	$146.72	$1,000,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $48.89 / $70.15 / $116.87	Professional		$48.89	$70.15	$116.87