Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $546.63 / $546.63 / $546.63	Facility		$546.63	$546.63	$546.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.42 / $507.59 / $634.04	Professional		$340.42	$507.59	$634.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $730.30 / $803.33 / $1,329.15	Facility		$730.30	$803.33	$1,329.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $563.41 / $679.18 / $985.90	Professional		$563.41	$679.18	$985.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.49 / $156.28 / $156.28	Facility		$51.49	$156.28	$156.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $356.59 / $484.57 / $3,079.04	Facility		$356.59	$484.57	$3,079.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.10 / $862.50 / $1,078.13	Professional		$303.10	$862.50	$1,078.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $66.48 / $373.95 / $819.95	Facility		$66.48	$373.95	$819.95
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $87.64 / $528.55 / $528.55	Professional		$87.64	$528.55	$528.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.03 / $781.53 / $3,879.83	Facility		$73.03	$781.53	$3,879.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $349.13 / $465.51 / $768.45	Professional		$349.13	$465.51	$768.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.32 / $58.40 / $543.00	Professional		$1.32	$58.40	$543.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $66.48 / $546.63 / $868.54	Facility		$66.48	$546.63	$868.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $87.64 / $528.55 / $528.55	Professional		$87.64	$528.55	$528.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.54 / $172.75 / $224.30	Professional		$81.54	$172.75	$224.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $356.59 / $1,316.94 / $3,879.83	Facility		$356.59	$1,316.94	$3,879.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $356.59 / $356.59	Professional		$58.89	$356.59	$356.59
United Facility/Professional Professional Modifier Low / Median / High Price $316.43 / $407.13 / $768.45	Professional		$316.43	$407.13	$768.45