Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.48 / $503.66 / $5,115.99	Facility		$166.48	$503.66	$5,115.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $135.13 / $207.75 / $207.75	Facility		$135.13	$207.75	$207.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $350.54 / $409.63 / $660.72	Facility		$350.54	$409.63	$660.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $150.72 / $191.95 / $450.48	Facility		$150.72	$191.95	$450.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $155.43 / $649.60 / $1,789.00	Facility		$155.43	$649.60	$1,789.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $138.16 / $191.95 / $450.48	Facility		$138.16	$191.95	$450.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $274.95 / $424.57 / $555.51	Professional		$274.95	$424.57	$555.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,315.00 / $1,315.00 / $1,315.00	Facility		$1,315.00	$1,315.00	$1,315.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,590.00 / $2,202.90	Facility		$1,034.00	$1,590.00	$2,202.90