Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $490.84 / $490.84 / $490.84	Facility		$490.84	$490.84	$490.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.77 / $453.79 / $553.23	Professional		$295.77	$453.79	$553.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $708.80 / $779.68 / $1,290.02	Facility		$708.80	$779.68	$1,290.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $444.12 / $659.18 / $871.82	Professional		$444.12	$659.18	$871.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.98 / $151.68 / $151.68	Facility		$49.98	$151.68	$151.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $1,919.39 / $2,981.07	Facility		$150.00	$1,919.39	$2,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $832.50 / $1,040.63	Professional		$127.50	$832.50	$1,040.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.38 / $283.37 / $736.26	Facility		$50.38	$283.37	$736.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $85.06 / $400.56 / $400.56	Professional		$85.06	$400.56	$400.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.88 / $575.49 / $2,247.90	Facility		$70.88	$575.49	$2,247.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $249.43 / $347.97 / $547.39	Professional		$249.43	$347.97	$547.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.30 / $58.40 / $534.31	Professional		$1.30	$58.40	$534.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $50.38 / $471.77 / $736.26	Facility		$50.38	$471.77	$736.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $85.06 / $400.56 / $400.56	Professional		$85.06	$400.56	$400.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.14 / $153.03 / $198.69	Professional		$79.14	$153.03	$198.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $809.14 / $2,247.90	Facility		$150.00	$809.14	$2,247.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.43 / $150.00 / $150.00	Professional		$54.43	$150.00	$150.00
United Facility/Professional Professional Modifier Low / Median / High Price $225.16 / $315.79 / $547.39	Professional		$225.16	$315.79	$547.39