Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $647.42 / $647.42 / $647.42	Facility		$647.42	$647.42	$647.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $396.76 / $586.34 / $777.06	Professional		$396.76	$586.34	$777.06
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 $639.16 / $687.27 / $997.65	Professional		$639.16	$687.27	$997.65
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 $578.29 / $745.56 / $3,107.03	Facility		$578.29	$745.56	$3,107.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $491.56 / $866.25 / $1,082.81	Professional		$491.56	$866.25	$1,082.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $512.10 / $971.15	Facility		$84.99	$512.10	$971.15
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $112.37 / $112.37	Professional		$88.68	$112.37	$112.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.37 / $1,932.07 / $3,720.55	Facility		$112.37	$1,932.07	$3,720.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.19 / $112.37 / $906.00	Professional		$48.19	$112.37	$906.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.39 / $58.40 / $569.57	Professional		$1.39	$58.40	$569.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $73.90 / $540.00 / $971.15	Facility		$73.90	$540.00	$971.15
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $112.37 / $112.37	Professional		$88.68	$112.37	$112.37
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 $578.29 / $1,758.76 / $3,720.55	Facility		$578.29	$1,758.76	$3,720.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.82 / $578.29 / $578.29	Professional		$59.82	$578.29	$578.29
United Facility/Professional Professional Modifier Low / Median / High Price $48.19 / $127.11 / $780.18	Professional		$48.19	$127.11	$780.18