Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $601.37 / $601.37 / $601.37	Facility		$601.37	$601.37	$601.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.15 / $544.89 / $679.50	Professional		$363.15	$544.89	$679.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $739.00 / $812.90 / $1,344.98	Facility		$739.00	$812.90	$1,344.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $618.54 / $687.27 / $923.75	Professional		$618.54	$687.27	$923.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.10 / $158.15 / $158.15	Facility		$52.10	$158.15	$158.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $559.40 / $2,273.28 / $3,586.13	Facility		$559.40	$2,273.28	$3,586.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $866.25 / $1,082.81	Professional		$59.64	$866.25	$1,082.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $79.89 / $449.37 / $902.06	Facility		$79.89	$449.37	$902.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $635.17 / $635.17	Professional		$88.68	$635.17	$635.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.89 / $912.95 / $3,720.55	Facility		$79.89	$912.95	$3,720.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $397.71 / $554.83 / $891.19	Professional		$397.71	$554.83	$891.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.47 / $58.40 / $605.98	Professional		$1.47	$58.40	$605.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $79.89 / $601.37 / $902.06	Facility		$79.89	$601.37	$902.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $635.17 / $635.17	Professional		$88.68	$635.17	$635.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.51 / $165.65 / $215.08	Professional		$82.51	$165.65	$215.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $559.40 / $1,339.24 / $3,720.55	Facility		$559.40	$1,339.24	$3,720.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $59.64 / $577.92	Professional		$59.64	$59.64	$577.92
United Facility/Professional Professional Modifier Low / Median / High Price $357.19 / $500.98 / $891.19	Professional		$357.19	$500.98	$891.19