Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $779.65 / $779.65 / $779.65	Facility		$779.65	$779.65	$779.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $751.68 / $909.01 / $961.46	Facility		$751.68	$909.01	$961.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $279.68 / $279.68 / $1,459.92	Professional		$279.68	$279.68	$1,459.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $532.05 / $854.44 / $854.44	Facility		$532.05	$854.44	$854.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $962.40 / $1,124.64 / $1,814.00	Facility		$962.40	$1,124.64	$1,814.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $413.90 / $941.46 / $1,069.83	Professional		$413.90	$941.46	$1,069.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $269.20 / $419.54 / $1,223.67	Facility		$269.20	$419.54	$1,223.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $314.66 / $419.54 / $1,223.67	Facility		$314.66	$419.54	$1,223.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $209.77 / $1,078.18	Professional		$174.81	$209.77	$1,078.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $269.20 / $419.54 / $1,223.67	Facility		$269.20	$419.54	$1,223.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $583.74 / $833.78 / $1,169.43	Professional		$583.74	$833.78	$1,169.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $699.24 / $1,660.70 / $1,660.70	Facility		$699.24	$1,660.70	$1,660.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,398.48 / $1,748.10 / $1,748.10	Professional		$1,398.48	$1,748.10	$1,748.10
United Facility/Professional Facility Modifier Low / Median / High Price $419.54 / $419.54 / $419.54	Facility		$419.54	$419.54	$419.54
United Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $223.86 / $650.78	Professional		$174.81	$223.86	$650.78