Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $514.29 / $514.29 / $514.29	Facility		$514.29	$514.29	$514.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.95 / $460.22 / $589.23	Professional		$313.95	$460.22	$589.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $714.70 / $786.17 / $1,300.75	Facility		$714.70	$786.17	$1,300.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $480.38 / $664.67 / $879.08	Professional		$480.38	$664.67	$879.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.39 / $152.94 / $152.94	Facility		$50.39	$152.94	$152.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $255.74 / $1,937.41 / $3,009.06	Facility		$255.74	$1,937.41	$3,009.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.38 / $840.00 / $1,050.00	Professional		$217.38	$840.00	$1,050.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.68 / $318.83 / $771.44	Facility		$56.68	$318.83	$771.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $85.76 / $450.53 / $450.53	Professional		$85.76	$450.53	$450.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.47 / $647.48 / $2,570.06	Facility		$71.47	$647.48	$2,570.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $285.17 / $397.84 / $625.83	Professional		$285.17	$397.84	$625.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.26 / $58.40 / $515.78	Professional		$1.26	$58.40	$515.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.68 / $514.29 / $771.44	Facility		$56.68	$514.29	$771.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $85.76 / $450.53 / $450.53	Professional		$85.76	$450.53	$450.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.80 / $161.69 / $209.96	Professional		$79.80	$161.69	$209.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $255.74 / $925.10 / $2,570.06	Facility		$255.74	$925.10	$2,570.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.76 / $255.74 / $255.74	Professional		$56.76	$255.74	$255.74
United Facility/Professional Professional Modifier Low / Median / High Price $253.34 / $340.55 / $622.26	Professional		$253.34	$340.55	$622.26